Lowitja Associated Research

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The Lowitja Institute’s pioneering research projects and scholarship initiatives have significantly influenced health research worldwide. This collection includes research outputs that either reference publications by the Lowitja Institute or utilise our research tools.
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A collaborative Indigenous-non-Indigenous partnership approach to understanding participant experiences of a community-based healthy lifestyles program.
(2021-08-27) Wild C.E.K.; Rawiri N.T.; Cormack D.M.; Willing E.J.; Hofman P.L.; Anderson Y.C.
We describe the approach of an Indigenous-non-Indigenous research partnership in the context of a qualitative study which aimed to understand barriers and facilitators to engagement in a community-based healthy lifestyles program in Aotearoa/New Zealand. Informed by Kaupapa Maori research principles and by "Community-Up" research values, this collaborative approach between the mixed Maori-non-Maori research team effectively engaged with Maori and non-Maori families for in-depth interviews on participant experience, including with non-service users. "Community-Up" research principles allowed for a respectful process which upheld the mana (status, dignity) of the interview participants and the research team. Challenges included maintaining flexibility in our conceptions of ethnicity to reflect the complexity of modern family life in Aotearoa/New Zealand. We were committed to ongoing communication, awareness, and attention to the relationships that formed the basis of our research partnership, which allowed effective navigation of challenges and was critical to the study's success.
A comprehensive analysis of well-being frameworks applied in Australia and their suitability for Indigenous peoples.
Sangha K.K; Dinku Y.; Costanza R.; Poelina A.
Purpose: Well-being is a complex, multi-dimensional, dynamic, and evolving concept, covering social, economic, health, cultural and spiritual dimensions of human living, and often used synonymously with happiness, life satisfaction, prosperity, and quality of life. We review the existing key wellbeing frameworks applied in Australia both for the wider public and Indigenous peoples. The aim is to provide a comprehensive overview of various applied frameworks, along with a critical analysis of domains or dimensions comprising those frameworks, and to analyse the role of nature in those frameworks. Methodology: We conducted a critical analysis of the main frameworks applied in Australia to date to measure the well-being of the mainstream (mainly non-Indigenous) and Indigenous populations. This study is particularly timely given the Australian Government's interest in revising the well-being frameworks as mentioned in the Government "Measuring What Matters" statement. Results: The existing well-being frameworks in Australia either overlook or hardly consider the role of nature and its services which are important to support human well-being. Likewise, for Indigenous peoples "Country" (Indigenous clan land) is vital for their well-being as their living is imbued with "Country". The role of nature/"Country" needs to be considered in revising the well-being frameworks, indicators and measures to inform and develop appropriate policies and programs in Australia. Conclusion: To develop appropriate welfare policies and programs for achieving socio-economic and other wellbeing outcomes, it is essential to evolve and conceptualize wellbeing frameworks (and related indicators and measures) in line with people's contemporary values, particularly considering the role of nature and its services. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
A flow that comes when we're talking: water metaphors for exploring intercultural communication during early childhood assessment interactions in a Yolnu (First Nations Australian) community.
Armstrong E.; Maypilama L.; Bukulatjpi Y.; Gapany D.; Fasoli L.; Ireland S.; Baker R.D.; Hewat S.; Lowell A.; Yolnu
Culture mediates how all people think and communicate and intercultural communication skills are required for effective collaboration. This study (2017-2021) explored intercultural communication with 40 participants in one very remote First Nations Australian community in Northern Australia. We explored the perspectives of both Yolnu (First Nations Australian people from North-East Arnhem Land) and Balanda (non-Indigenous people, in this case Australian) on interactions during early childhood assessments of Yolnu children (0-6 years). Our intercultural research team used a culturally responsive form of video-reflexive ethnography, a Yolnu approach to in-depth discussion and collaborative analysis. In this article, we explore nine intercultural communication processes that were recognized and enacted by study participants. Each process is represented by a metaphor drawn from water traveling in North-East Arnhem Land. We share these processes so that others may consider exploring their relevance in other intercultural communication contexts. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
A framework to assess cultural safety in Australian public policy.
(2020-12-29) Mackean T.; Fisher M.; Friel S.; Baum F.
The concept of cultural safety (CS) has been developed as a critical perspective on healthcare provided to Indigenous service users in neo-colonial countries such as New Zealand, Australia and Canada. Unlike other frameworks for culturally competent healthcare, a CS approach recognizes impacts of colonization and power inequalities on Indigenous peoples and asks how these may manifest in healthcare settings. It has been argued that CS thinking is suited to critical analysis of public policy, but there has been limited work in this direction. Drawing on literature on CS in Australian healthcare, we defined a CS framework consisting of five concepts: reflexivity, dialogue, reducing power differences, decolonization and regardful care. Our research examined whether and in what terms this framework could be adapted as a tool for critical analysis of Australian public policy as it affects Aboriginal and Torres Strait Islander peoples. We used a collaborative inquiry process combining perspectives of an Aboriginal researcher and a non-Indigenous researcher. We developed a thematic analysis framework to examine how the five concepts might be reflected in contemporary writings on policy by leading Aboriginal or Torres Strait Islander thinkers. We found the framework is applicable as a tool for policy analysis; bringing together key concerns raised by Aboriginal and Torres Strait Islander leaders and critical concepts such as sovereignty and interface thinking. We concluded the framework is likely to be a useful tool for critical, systemic thinking about public policy as it affects Indigenous peoples and for specifying areas where performance can be improved to achieve culturally safe policy.Copyright © The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
A need for tailored programs and policies to reduce rates of alcohol-related crimes for vulnerable communities and young people: an analysis of routinely collected police data.
(2018-10-29) Snijder M.; Calabria B.; Dobbins T.; Knight A.; Shakeshaft A.
Background and aims: Given ongoing community concern about high rates of alcohol-related crimes (ARCs) experienced by disadvantaged populations, a more specific and nuanced understanding of factors associated with ARCs would help inform the development of more sophisticated programs and policies aimed at reducing ARCs. This study estimates rates of ARCs across all communities in New South Wales (NSW), Australia, using routinely collected police data; investigates whether there are differences between communities; and identifies individual and community characteristics that are significantly associated with higher rates of ARCs. Short summary: This study analysed routinely collected police data in New South Wales, Australia, to identify individual and community characteristics associated with alcohol-related crimes. Young people, Aboriginal Australians, socio-economically disadvantaged communities, remote and regional communities and communities with higher per capita rate of on-venue liquor licenses are at risk of alcohol-related crimes. Method(s): Age standardized rates of ARCs were calculated. A multi-level Poisson regression analysis was conducted to investigate the individual and community factors that were statistically significantly associated with higher rates of ARC, separately for Aboriginal and non-Aboriginal Australians. Result(s): Rates of ARCs were statistically significantly higher for Aboriginal Australians, young people (aged 13-37 years) and on weekends. ARCs varied significantly across communities, and were significantly higher in remote or regional communities, in communities with a higher per capita rate of on-venue licences, and for socio-economically disadvantaged communities for non- Aboriginal Australians, but not for Aboriginal females. Conclusion(s): This analysis shows that the impact of national-level and jurisdictional-level legislation and policies is uneven across communities and defined populations, leaving young people, socio-economically disadvantaged communities and Aboriginal Australians at increased risk of ARCs. To more equitably reduce the exposure of all Australians to ARC, mechanisms that effectively engage vulnerable communities and defined populations, need to be developed in consultation with them, implemented and evaluated.Copyright © 2018 The Author(s).
A network approach to policy framing: a case study of the national Aboriginal and Torres Strait Islander health plan.
(2016-11-24) Browne J.; de Leeuw E.; Gleeson D.; Adams K.; Atkinson P.; Hayes R.
Aboriginal health policy in Australia represents a unique policy subsystem comprising a diverse network of Aboriginal-specific and "mainstream" organisations, often with competing interests. This paper describes the network structure of organisations attempting to influence national Aboriginal health policy and examines how the different subgroups within the network approached the policy discourse. Public submissions made as part of a policy development process for the National Aboriginal and Torres Strait Islander Health Plan were analysed using a novel combination of network analysis and qualitative framing analysis. Other organisational actors in the network in each submission were identified, and relationships between them determined; these were used to generate a network map depicting the ties between actors. A qualitative framing analysis was undertaken, using inductive coding of the policy discourses in the submissions. The frames were overlaid with the network map to identify the relationship between the structure of the network and the way in which organisations framed Aboriginal health problems. Aboriginal organisations were central to the network and strongly connected with each other. The network consisted of several densely connected subgroups, whose central nodes were closely connected to one another. Each subgroup deployed a particular policy frame, with a frame of "system dysfunction" also adopted by all but one subgroup. Analysis of submissions revealed that many of the stakeholders in Aboriginal health policy actors are connected to one another. These connections help to drive the policy discourse. The combination of network and framing analysis illuminates competing interests within a network, and can assist advocacy organisations to identify which network members are most influential.Copyright © 2016 Elsevier Ltd
A postcolonial analysis of Indigenous cultural awareness training for health workers.
Downing R.; Kowal E.
Indigenous cultural training for health workers is an increasingly popular intervention designed to improve the health services provided to Indigenous peoples in Australia. The provision of this training is based on the recognition that the measured discrepancy between Indigenous and non-Indigenous health outcomes is in part influenced by cultural difference and a history of racism in Australian society. Indigenous cultural training in Australia predominantly draws on a 'cultural awareness' framework which seeks to educate health workers about 'Indigenous culture'. To date, evaluations of Indigenous cultural training programs have found them to have questionable efficacy, although most of these evaluations have been methodologically inadequate. This article draws on postcolonial theory to explore the limitations of Indigenous cultural training as it is commonly conceptualised. Issues of essentialising 'Indigenous culture', 'otherness' and the absence of systemic responsibility for culturally appropriate health service provision are discussed. Finally, we consider future directions for Indigenous cultural training that are useful to both Indigenous service users and the health workers charged with 'closing the gap' between Indigenous and non-Indigenous health outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
A systematic review of EPDS cultural suitability with Indigenous mothers: a global perspective.
(2020-12-01) Chan A.W.; Reid C.; Skeffington P.; Marriott R.
The Edinburgh Postnatal Depression Scale (EPDS) is used extensively as the "gold standard" perinatal depression and anxiety screening tool. This study contributes to an emerging discussion about the tool's shortcomings, specifically around cultural suitability for use with Indigenous women. A systematic search was conducted in ProQuest, PsycINFO, MEDLINE (Web of Science), PubMed, Scopus, Informit, and CINAHL research databases, and grey literature. The quality of the body of evidence was assessed using the NHMRC Level of Evidence framework. Three studies supported the cultural validation of the EPDS with Indigenous groups in Canada (n = 2) and the USA (n = 1). The remaining eleven Australian studies demonstrated that cultural concerns were suggested by either Indigenous mothers, healthcare professionals (Indigenous and non-Indigenous), or both, though cultural concerns were more weighted from the perspectives of healthcare professionals. The quality of the evidence was not strong, and thus, there is a critical and urgent need for targeted research in this area. This review identified and recommended Indigenous-specific methodologies that can be adopted for more trustworthy, culturally safe, and effective research in this area. Given that the EPDS is currently considered gold standard in routine perinatal mental health screening practice in countries around the world, these findings raise significant concerns. Using culturally relevant research methodologies, such as the use of mixed-methods design, could lay stronger groundwork for further investigation of the broader utility and cultural relevance of the tool.Copyright © 2020, The Author(s).
Aboriginal and Torres Strait Islander children with obesity: a review of programmes for children and young people aged 5-17 years.
(2023-03-17) Wallace S.; Scarcella M.; Sealy L.; Alexander S.; Zwi K.
A literature review of overweight and obesity prevention and management programmes for Australian Aboriginal and Torres Strait Islander children 5-17 years to inform a co-design weight management intervention in an urban Aboriginal community. Systematic searching of PubMed, Science Direct, Lowitja LitSearch and hand-searching of references, government and Aboriginal websites. Programmes were categorised as including nutrition and food literacy, cooking skills, health education and cultural components. Quality was assessed against the CREATE QAT Tool. Eight programmes, including two evaluations and six programme descriptions, were identified. Interventions ranged in duration from 1 day to 10 weeks involving nutrition education, health information, cooking skills, exercise and cultural content. There were no significant reductions in weight outcomes, although there were reported positive health changes to the children including a reduction in waist circumference and an increase in exercise levels. Insights for future research include effective co-design with community and the delivery of flexible content through an Aboriginal-led, multifaceted programme. There is limited evidence for the prevention and management of weight in Aboriginal children with overweight and obesity. Future research efforts should include more time-intensive, multifaceted, community-run programmes that are supported by medical, advocacy and evaluation expertise from health services.Copyright © 2022 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
Aboriginal and Torres Strait Islander social and emotional wellbeing and mental health.
Calma T.; Dudgeon P.; Bray A.
Closing the Aboriginal and Torres Strait Islander mental health gap is an urgent national priority. This commentary provides both an overview of Aboriginal and Torres Strait Islander social and emotional well being and mental health and some of the promising initiatives for restoring wellbeing. Solutions for addressing Aboriginal and Torres Strait islander mental health issues require a "best of both worlds" approach which acknowledges the impact of social and cultural determinants on Aboriginal and Torres Strait Islander wellbeing. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Aboriginal community-controlled art centres: keeping elders strong and connected. Articulating an ontologically situated, intergenerational model of care.
Mackell P.; Squires K.; Cecil J.; Lindeman M.; Fraser S.; Malay R.; Meredith M.; Young M.; Nargoodah L.; Cook B.; Schmidt C.; Dow B.; Batchelor F.
Objective: To articulate how Aboriginal community-controlled art centres support the role of Elders and older people within an ontologically situated, intergenerational model of care. Methods: In this paper, we draw on stories (data) generated through interviews involving 75 people associated with three Aboriginal community-controlled art centres and field notes taken during a Participatory Action Research (PAR) study. The study was undertaken in collaboration with three community-controlled art centres and two aged care providers over almost 4 years, in diverse Indigenous sovereignties, all located in geographically remote Australian locations. Results: Engaging with decolonising and Indigenous theoretical frameworks, our analysis identified three interwoven meta-themes. These include connection to law and culture; purpose; and healing. Each theme had important subthemes, and all were central to upholding the well-being of older people and their families, as well as the art centre workforce, Country, and their broader communities. Conclusions: Our analysis articulates an ontologically situated model of care within Aboriginal community-controlled art centres. The model sees that older people receive care from art centres and provide care to each other, to younger generations, to art centre staff, to Country, and to their broader communities. In this model, those in receipt of care, many of whom are older people, art centre directors, and important artists, govern how care is conceptualised and delivered. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Aboriginal perceptions of social and emotional wellbeing programs: a systematic review of literature assessing social and emotional wellbeing programs for Aboriginal and Torres Strait Islander Australians perspectives.
Murrup-Stewart C.; Searle A.K.; Jobson L.; Adams K.
Australian Aboriginal and Torres Strait Islander communities have been targets of social and emotional wellbeing programs for many years. However, the few health-care programs and services that are evaluated rarely provide insight into the participants' perspectives of program success or failure. This systematic review assessed 33 social and emotional wellbeing programs across Australia to better understand what Aboriginal community members think about the programs and how they could be improved. Results highlighted the interesting and valuable insights provided by Aboriginal participants, including what kinds of program activities and approaches are most suitable, what program characteristics are successful or desired, and their experiences of wellbeing change before and after program participation. They likewise voiced opinions about poorly received programs, culturally inappropriate services and negative experiences. This review highlighted how health and wellbeing programs must better engage Aboriginal and Torres Strait Islander clients to ensure that services are culturally safe, holistic, integrate appropriate staffing, include culturally relevant activities and value patient/participant experiences. These findings have significant implications for the health and wellbeing sector; specifically, research, policy, program design and implementation, evaluation methods, and self-determination. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Aboriginal perspectives of child health and wellbeing in an urban setting: developing a conceptual framework.
Priest N.; Mackean T.; Davis E.; Briggs L.; Waters E.
Health and wellbeing is defined internationally as a multi-dimensional and holistic concept, particularly within Indigenous worldviews. However, in Australia there is a lack of detailed frameworks supporting such definitions that are founded on Aboriginal knowledges. This study aimed to explore Aboriginal perspectives of child health and wellbeing in an urban setting. Qualitative interviews with 25 care-givers of Aboriginal children living in Melbourne, Australia were conducted. Aboriginal people and community controlled organisations were collaborative partners in all stages of the research. A conceptual framework of Aboriginal child health and wellbeing in an urban setting was developed comprising four main themes: Strong Culture; Strong Child; Strong Environment; and Strengths and Challenges. Aboriginal conceptions of culture are considered central to Aboriginal child health and wellbeing in an urban context. A holistic framework that privileges Aboriginal knowledge of child health and wellbeing has not previously been available. Further exploration of socio-ecological models within Aboriginal child health and wellbeing contexts is needed. This study identifies dimensions for further exploration in research, policy and practice. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Adaptation of the ages and stages questionnaire for remote Aboriginal Australia.
(2017-03-23) D'Aprano A.; Silburn S.; Johnston V.; Robinson G.; Oberklaid F.; Squires J.
A key challenge to providing quality developmental care in remote Aboriginal primary health care (PHC) centers has been the absence of culturally appropriate developmental screening instruments. This study focused on the cross-cultural adaptation of the Ages and Stages Questionnaires, 3rd edition (ASQ-3), with careful attention to language and culture. We aimed to adapt the ASQ-3 for use with remote dwelling Australian Aboriginal children, and to investigate the cultural appropriateness and feasibility of the adapted ASQ-3 for use in this context. We undertook a qualitative study in two remote Australian Aboriginal communities, using a six-step collaborative adaptation process. Aboriginal Health Workers (AHWs) were trained to use the adapted ASQ-3, and follow-up interviews examined participants' views of the cultural acceptability and usefulness of the adapted instrument. The adapted ASQ-3 was found to have high face validity and to be culturally acceptable and relevant to parents, AHWs, and early childhood development experts. Copyright © The Author(s) 2014.
Addressing Indigenous substance misuse and related harms.
Gray D.; Pulver L.J.; Saggers S.; Waldon J.
Substance misuse and its consequences among Indigenous minority populations in countries such as Australia, New Zealand/Aotearoa, Canada and the United States is a major health and social problem. We were approached by the Editorial Board of Drug and Alcohol Review to edit this Special Section of Indigenous Substance Misuse Issues. The work described in the papers cover a range of substances-petrol, tobacco, alcohol and illicit drugs. Seven of the eight papers presented are authored or co-authored by Indigenous people. One of the papers focuses on the reduction of alcohol-related harm in a remote community. Another paper focuses upon an attempt to reduce alcohol-related harm in Alice Springs by means of a number of additional restrictions on licensed liquor outlets. The papers in this Special Section illustrate some important lessons for the drug and alcohol field about interventions and conducting research on substance misuse with Indigenous communities. However, the papers in this Special Section do not provide 'the answers' to substance misuse and related harms among Indigenous peoples. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
Advancing impactful research for adolescent health and wellbeing: key principles and required technical investments.
Azzopardi P.; Clark T.C.; Renfrew L.; Habito M.; Ameratunga S.
Purpose: Substantial progress in adolescent health research has been made over recent decades, but important knowledge gaps remain. Methods: Informed by targeted reviews of the literature, expert consultation, and authors' collective experiences, we propose future directions in adolescent health research. Results: We identified five key principles on how future research must be approached alongside what technical investments are required to act on them. Principles: 1. Research with adolescents must be decolonizing in practice, dismantling systems of oppression, exploitation, and cultural dominance; 2. Research must recognize socio-political, structural, and commercial determinants of adolescent health; 3. Research must be developmentally and contextually appropriate, reflecting adolescents' evolving capacities and increasingly complex and intersecting determinants of health; 4. Research must be strengths-based-moving away from problematizing adolescents and/or their behaviours toward focusing on their strengths as levers for change; and 5. Research must be built on a foundation of respectful partnerships as a right, and because adolescents have unique knowledge and skills to contribute. Technical investments: 1. Sampling techniques and approaches that provide equity of opportunity for all to participate; 2. High-quality descriptive studies from all nations to understand adolescents' ever-evolving contexts, needs and assets; 3. Investment in what works within each context and for whom through trials and robust assessments/evaluations; and 4. Implementation science research strategies. Discussion: Adolescent health research will require reorientation and innovation in both how we approach research and what technical investments are required to improve the health and wellbeing of adolescents now and into the future. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Against the use of the strengths and difficulties questionnaire for Aboriginal and Torres Strait Islander children aged 2-15 years.
Chau Tracey; Tiego Jeggan; Brown Louise; Coghill David; Jobson Laura; Montgomery Alicia; Murrup-Stewart Cammi; Sciberras Emma; Silk Tim J; Spencer-Smith Megan; Stefanac Nicole; Sullivan Daniel P; Bellgrove Mark A
Objective: The Strengths and Difficulties Questionnaire is a widely used screening tool for emotional and behavioural problems in children. Recent quantitative analyses have raised concerns regarding its structural validity in Aboriginal and Torres Strait Islander communities. This paper aims to extend upon existing findings by analysing the factor structure of both the parent- and teacher-reported Strengths and Difficulties Questionnaire in this population across a broader age range than in previous studies. Methods: Participants were the caregivers and teachers of 1624 Aboriginal and Torres Strait Islander children (820 male, 804 female) aged 2-15 years from Waves 2-11 of the Longitudinal Study of Indigenous Children. The majority of children were Aboriginal living in major cities and inner regional areas. Internal consistency was estimated with McDonald's Omega. Exploratory structural equation modelling was conducted to investigate the factor structure of the parent-reported and teacher-reported versions of the Strengths and Difficulties Questionnaire. Results: Responses from teachers demonstrated higher internal consistency than responses from parents, which was unacceptably low across most age groups. The purported five-factor structure of the Strengths and Difficulties Questionnaire failed to be replicated across both parent- and teacher-reported questionnaires. The results of bifactor and hierarchical exploratory structural equation models also failed to approximate the higher-order summary scales. These results indicate that the Strengths and Difficulties Questionnaire subscales and summary scores do not provide a valid index of emotional and behavioural problems in Aboriginal and Torres Strait Islander children. Conclusion: The Strengths and Difficulties Questionnaire should not be used with Aboriginal and Torres Strait Islander children. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Amazingly resilient Indigenous people! Using transformative learning to facilitate positive student engagement with sensitive material.
(2014-05-13) Jackson D.; Power T.; Sherwood J.; Geia L.
If health professionals are to effectively contribute to improving the health of Indigenous people, understanding of the historical, political, and social disadvantage that has lead to health disparity is essential. This paper describes a teaching and learning experience in which four Australian Indigenous academics in collaboration with a non-Indigenous colleague delivered an intensive workshop for masters level post-graduate students. Drawing upon the paedagogy of Transformative Learning, the objectives of the day included facilitating students to explore their existing understandings of Indigenous people, the impact of ongoing colonisation, the diversity of Australia's Indigenous people, and developing respect for alternative worldviews. Drawing on a range of resources including personal stories, autobiography, film and interactive sessions, students were challenged intellectually and emotionally by the content. Students experienced the workshop as a significant educational event, and described feeling transformed by the content, better informed, more appreciative of other worldviews and Indigenous resilience and better equipped to contribute in a more meaningful way to improving the quality of health care for Indigenous people. Where this workshop differs from other Indigenous classes was in the involvement of an Indigenous teaching team. Rather than a lone academic who can often feel vulnerable teaching a large cohort of non-Indigenous students, an Indigenous teaching team reinforced Indigenous authority and created an emotionally and culturally safe space within which students were allowed to confront and explore difficult truths. Findings support the value of multiple teaching strategies underpinned by the theory of transformational learning, and the potential benefits of facilitating emotional as well as intellectual student engagement when presenting sensitive material.
Amplifying Indigenous voice and curriculum within the public health academy - the emergence of Indigenous sovereign leadership in public health education.
Ahuriri-Driscoll A.; Lee V.; Came H.
In April 2019, educators from around Aotearoa (New Zealand) and Australia came together to share their experiences of teaching Indigenous public health. The inaugural International Indigenous Public Health Education Leadership Symposium provided an opportunity to (i) discuss the range of challenges of this work, and (ii) to affirm a collective aspiration to strengthen the contribution of public health education to improved Indigenous outcomes. Talking across the borders of individual institutions, distinct cultures and nations enabled a rich conversation about the interface of health and Indigenous education. We explored the twin agendas of decolonisation and indigenisation, meeting the respective needs of Indigenous and non-Indigenous students, and how to best mobilise Indigenous public health leadership. This article will outline the discussion that unfolded and that led to the establishment of an inclusive Australia/Aotearoa/South Pacific Indigenous public health education entity and network. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
Amplifying older Aboriginal and Torres Strait Islander women's perspectives to promote digital health equity: co-designed qualitative study.
Henson Connie; Chapman Felicity; Shepherd Gina; Carlson Bronwyn; Rambaldini Boe; Gwynne Kylie
Background: Digital health is becoming ubiquitous, and we must ensure equity in access. Indigenous people across most high-income countries typically have not benefited as much as other citizens from usual health care systems and technologies. Despite Aboriginal and Torres Strait Islander people's clear interest in, and enthusiastic use of, new technologies, little research has examined the needs or interests of older Aboriginal and Torres Strait Islander women. Objective: This study prioritizes the perspectives of older Aboriginal and Torres Strait Islander women, tapping into their expertise associated with Indigenous ways of knowing, being, and doing, as well as their unique position within their families and communities, to design a model for using digital technologies to improve health for themselves and their families as well as their communities. Methods: Older Aboriginal and Torres Strait Islander women from 4 partner organizations were recruited for this study. This co-designed qualitative research included citizen scientists in shaping the protocol as well as collecting, analyzing, and interpreting data. We used yarning, an Indigenous research method validated for use in health research with Indigenous people and seen as respectful and culturally safe, as a primary research tool. The use of Indigenous methodologies and our iterative process enabled us to deeply explore and incorporate perspectives from all participants and ensure that the perspectives of Indigenous citizen scientists with lived experience were privileged. The data-checking methods also used a yarning methodology, which ensured that the findings and translational model derived from the findings were validated by the participants. Results: Participants comprised 24 Aboriginal and Torres Strait Islander women aged >=41 years and including 3 generations that did not grow up with the internet: seniors, baby boomers, and Generation X. The key findings in this research were that older women use various digital technologies to improve health and well-being for themselves and their families as well as their communities. Older Aboriginal women want a culturally sensitive cyberspace that caters specifically to their needs and includes relevant content and functionality that are accessible and efficient. Our translational model highlights the conditions necessary for anyone to use digital health technologies, summarizes the essential elements needed to promote equity in digital health, and illuminates the unmet needs and requirements for older Aboriginal and Torres Strait Islander women to fully benefit from digital health technologies. Conclusions: Health is a fundamental right. As we move toward greater reliance on digital health solutions, we must recognize and address the concerns of the smaller populations of people who differ in their needs. We must urgently address the financial, connectivity, and other limiting factors highlighted by older Aboriginal and Torres Strait Islander women in this study that limit equitable access to digital health tools. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

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