Lowitja Funded Scholars

Lowitja Institute Scholarships aim to support the next generation of Aboriginal and Torres Strait Islander health researchers. Our scholarships contribute to Aboriginal and Torres Strait Islander leadership of health research by providing opportunities for Aboriginal and Torres Strait Islander people to develop skills in areas relevant to meaningful health research. This collection contains the research publications from Lowitja supported scholars.
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Yarning about foot care: evaluation of a foot care service for Aboriginal and Torres Strait Islander peoples.
(2022-04-12) West M.; Sadler S.; Charles J.; Hawke F.; Lanting S.; Munteanu S.E.; Chuter V.
Background: Aboriginal and Torres Strait Islander Peoples have high rates of diabetes-related foot disease including foot ulcer and amputation. There has been limited evaluation of foot care services for Aboriginal and Torres Strait Islander Peoples. This project aimed to evaluate an Aboriginal and Torres Strait Islander foot care service (the Buridja Clinic) for prevention and management of diabetes-related foot disease embedded in a university podiatry program from a Community perspective using culturally appropriate methods. Method(s): This mixed-methods study took place from March 2018 to April 2021 in the Buridja Clinic on the Central Coast of New South Wales, Australia, and included an audit of occasions of service (March 2018 to March 2020), and review of the Buridja Clinic via research yarns with Aboriginal and Torres Strait Islander clients of the clinic and a written 10-item customised clinic feedback survey. Research yarns were transcribed and analysed thematically. Descriptive analysis of quantitative occasions of use and survey data was undertaken, with the open-ended survey responses thematically analysed. Result(s): Total occasions of service across the review period was 548, with a total of 199 individual clients treated. Most common service types were general treatments (nail and skin care) and diabetes assessments. Nine participants who attended the Buridja Clinic were recruited to the two research yarns. An additional 52 participants who attended the clinic completed the customised clinic feedback survey. Specific clinic design elements, including yarning circles and group booking as well as student placement, were identified as strengths of the clinic. Participants reported difficulty with transport and restricted opening hours and encouraged increased Community engagement by clinic staff. Conclusion(s): Evaluation of a foot care service for Aboriginal and Torres Strait Islander Peoples embedded in a university-based podiatry program demonstrated that the incorporation of specific service design elements, including yarning circles and group appointments as well as student placements, encouraged ongoing Community engagement with the service. Participants reported improved foot health, greater foot and self-care knowledge, and overall better general health and management as a result of attendance to the clinic. Consideration needs to be given to addressing limited access to transport and flexible operating hours when establishing similar services. Graphical abstract: [Figure not available: see fulltext.] Artist Jenni McEwen (Bundjalung) lives on Darkinjung Country. The story of her art shows people sitting in yarning circles sharing knowledges but looking outwards to connect with Country too, the Ochre of Wiradjuri Country around Wellington, and the Blue of Darkinjung Country around Central Coast. These are locations where podiatry service provision takes place. These are locations where everyone is sharing and learning. Students, teachers, patients, non-Indigenous people, and First Nations people, learning from each other, and learning from Country. Copyright © 2022, The Author(s).
Yarning together: developing a culturally secure rehabilitation approach for Aboriginal Australians after brain injury.
(2020-01-31) Ciccone N.; Armstrong E.; Adams M.; Bessarab D.; Hersh D.; McAllister M.; Godecke E.; Coffin J.
Background and Objectives: Stroke and traumatic brain injury are more common in Aboriginal Australians than their non-Aboriginal counterparts, yet knowledge surrounding what constitutes a culturally secure and accessible rehabilitation service for Aboriginal Australians is sparse. This research (Lowitja Institute Funding 2018-2019) is working with Aboriginal people with an acquired communication disorder (ACD) following brain injury to (i) develop an understanding of the individual's perceptions of rehabilitation services and (ii) test the feasibility and acceptability of a culturally tailored model of speech pathology rehabilitation delivered via one of two modes: face to face or using telehealth technology. Method(s): Participants (n = 20) with an ACD after stroke or traumatic brain injury will be allocated to one of two groups: face-to-face therapy or therapy utilising telehealth technology and will receive 16 x 1 h treatment sessions provided twice weekly. Therapy utilises collaborative planning, integrates a yarning framework and is provided by a speech pathologist and Aboriginal co-worker. Improvement in participant communication skills is being measured through change in verbal output in discourse. The perspectives of the participants on the rehabilitation services accessed previously, the therapy provided through the study and change in everyday communication will be collected through semi-structured interviews. Result(s): This paper will present the therapy protocol, an explanation of the key elements involved in therapy implementation and some preliminary findings. Conclusion(s): The findings from this study will provide direction for rehabilitation therapists who provide services to Aboriginal brain injury survivors to improve quality of care.
'We just don't talk about it': Aboriginal and Torres Strait Islander peoples' perceptions of cancer in regional Queensland.
(2022-03-29) Meiklejohn J.A.; Arley B.D.; Pratt G.; Valery P.C.; Bernardes C.M.
Introduction: Disparities in cancer outcomes between Indigenous and non-Indigenous people are well reported. Some Australian Indigenous communities' beliefs about cancer may influence health behaviours, support for those with cancer and,ultimately, treatment outcomes. This project was instigated by request of a cultural adviser from a regional Queensland community and aims to make community perceptions of cancer visible, facilitate development of resources representing these perceptions and briefly evaluate the project from the community's perspective. Method(s): The project was guided by qualitative, participatory and visual research methodology. Community participation was engaged by identifying community champions who helped recruit interested community members and continued project momentum. The project was defined and driven by community, and a consensus decision making approach was used to select resources or activities to represent community perceptions of cancer and raise cancer awareness. Qualitative data were collected from yarning groups at two community forums and subsequent group sessions to explore and define community perceptions of cancer. Informed consent was obtained prior to audio-taped yarning groups. Data were also included from publicly available interviews broadcast on radio and television. All data about community perceptions of cancer and of the project were thematically analysed. Photovoice using cameras was the visual method chosen to capture images and stories representing community cancer beliefs. Result(s): Three main themes were derived from thematic analysis of data collected about community perceptions of cancer, identified by participants as important to improving cancer outcomes: (1) silence in the community, (2) support is important for survivorship and (3) awareness of cancer and the importance of sharing positive stories. A consensus decision-making approach resulted in the community choosing two resources to stimulate community discussion about cancer, raise awareness and reduce stigma. These were creating a community quilt, with each quilt square representing community perceptions of cancer, and producing a community calendar, with messages promoting healthy behaviours and cancer screening. The overall project was viewed as valuable for facilitating and improving the conversation about cancer with family, friends, the broader community and health professionals. Group sessions were considered important for providing a shared, safe space for support, for asking health related questions and as an instigator to share cancer related knowledge and stories with others. Conclusion(s): Silence around cancer may influence awareness and discussion about cancer, screening participation and help-seeking behaviour in this community. In this project, engaging with the community created a safe space for conversation around a previously taboo topic, which could lead to improved screening and help seeking behaviour. The role of primary health care in reducing health disparities by partnering with community to conduct awareness and prevention activities and by providing culturally appropriate care for Indigenous people is emphasised. Copyright © 2019, Rural and Remote Health. All Rights Reserved.
Using social media in health literacy research: a promising example involving Facebook with young Aboriginal and Torres Strait Islander males from the Top End of the Northern Territory.
(2021-08-10) Smith J.A.; Merlino A.; Christie B.; Adams M.; Bonson J.; Osborne R.H.; Drummond M.; Judd B.; Aanundsen D.; Fleay J.; Gupta H.
Unraveling common threads in obesity risk among racial/ethnic minority and migrant populations.
(2019-07-22) Kumanyika S.K.
Background: Epidemic obesity poses a major threat to global health. This phenomenon reflects the inability of the average person to cope, biologically and behaviorally, with environmental contexts that promote caloric overconsumption and inadequate caloric expenditure. There is still much to be learned about how to improve these contexts nationally and within-countries for sociodemographic groups with above-average obesity risks. Method(s): Higher obesity risks relative to respective white majority populations were identified among diverse Indigenous, other native-born, or migrant 'racial' or ethnic minority (hereafter, ethnic minority) populations in the United States, Canada, Australia, New Zealand, and the Netherlands, using publicly available national survey data or other sources. Cross-national comparisons were of interest for identifying common risk pathways associated with social and economic inequities. Potential explanations were explored through a narrative review of peer-reviewed literature, informed by the World Health Organization's Conceptual Framework for Action on The Social Determinants of Health. Main findings: Identifying viable solutions to the high risk of obesity in ethnic minority populations in these high-income countries requires examination of national-level social, economic, and health system contexts, food systems, and built environments for physical activity, as well as patterns of social stratification and cultural biases related to ethnicity, migration, and other determinants of social disadvantage. These factors can be linked to mediators of exposure or vulnerability to obesity-related risks, such as poverty, being an 'outsider', stress and trauma resulting from historical and current oppression, exposure to bias and discrimination, related biological or behavioral consequences, and inadequate health and social care. Conclusion(s): Focusing on ethnic minority populations in high-income countries is critical for public health efforts to address epidemic obesity. Mitigating intersecting risk pathways arising from stratification and bias based on ethnicity and migrant status should be prominent in these efforts.Copyright © 2019 The Royal Society for Public Health
To what extent could eliminating racial discrimination reduce inequities in mental health and sleep problems among Aboriginal and Torres Strait Islander children? A causal mediation study.
(2024-10-13) Priest N.; Guo S.; Wijesuriya R.; Chamberlain C.; Smith R.; Davis S.; Mohamed J.; Moreno-Betancur M.
Background: Racism is a fundamental cause of health inequities for Aboriginal and Torres Strait Islander children. We estimated the potential reduction in inequities in Aboriginal and Torres Strait Islander children's mental health and sleep problems if interpersonal racial discrimination was eliminated. Method(s): We drew on cross-sectional data from the Speak Out Against Racism (SOAR; N = 2818) and longitudinal data from the Longitudinal Study of Australian Children (LSAC; N = 8627). The SOAR was completed in 2017 and the LSAC followed children from 2004 to 2014 in the kindergarten cohort and from 2008 to 2018 in the birth cohort. Exposure: Aboriginal and Torres Strait Islander status (Aboriginal and Torres Strait Islander/Anglo-European), a proxy measure of structural racism (SOAR: 10-15 years; LSAC: 4-5 years); Mediator: interpersonal racial discrimination (yes/no) (SOAR: 10-15 years; LSAC: 12-13 years); Outcomes: mental health problems (yes/no) and sleep problems (yes/no) (SOAR: 10-15 years; LSAC: 14-15 years). An interventional effects causal mediation approach was used. Finding(s): Aboriginal and Torres Strait Islander children had higher prevalence of mental health problems (SOAR: 40.1% versus 13.5%; LSAC: 25.3% versus 7.6%) and sleep problems (SOAR: 28.5% versus 18.4%; LSAC: 14.0% versus 9.9%) than Anglo-European children. Hypothetical interventions eliminating Aboriginal and Torres Strait Islander children's experiences of interpersonal racial discrimination could reduce 42.4% and 48.5% of mental health and sleep inequities in SOAR (equivalent to 11.2% and 4.7% absolute reductions) and 25.6% and 1.6% of mental health and sleep inequities in LSAC (equivalent to 5.5% and 0.1% absolute reductions). Absolute remaining inequities were similar across both studies for both outcomes. Interpretation(s): Targeted policy interventions that eliminate racial discrimination against Aboriginal and Torres Strait Islander children could have high potential to reduce inequities in mental health and sleep problems. Addressing racism and racial discrimination needs a multi-component and multi-level approach directed by Aboriginal and Torres Strait Islander communities. Funding(s): National Health and Medical Research Council of Australia and Medical Research Future Fund of Australia.Copyright © 2024 The Author(s)
Time to clinical investigation for Indigenous and non-Indigenous Queensland women after a high grade abnormal pap smear, 2000-2009.
(2017-02-16) Whop L.J.; Baade P.D.; Brotherton J.M.L.; Canfell K.; Cunningham J.; Gertig D.; Lokuge K.; Garvey G.; Moore S.P.; Diaz A.; O'Connell D.L.; Valery P.; Roder D.M.; Condon J.R.
Objectives: To investigate time to follow-up (clinical investigation) for Indigenous and non-Indigenous women in Queensland after a high grade abnormality (HGA) being detected by Pap smear. Design, setting, participants: Population-based retrospective cohort analysis of linked data from the Queensland Pap Smear Register (PSR), the Queensland Hospital Admitted Patient Data Collection, and the Queensland Cancer Registry. 34 980 women aged 20e68 years (including 1592 Indigenous women) with their first HGA Pap smear result recorded on the PSR (index smear) during 2000e2009 were included and followed to the end of 2010. Main Outcome Measure(s): Time from the index smear to clinical investigation (histology test or cancer diagnosis date), censored at 12 months. Result(s): The proportion of women who had a clinical investigation within 2 months of a HGA finding was lower for Indigenous (34.1%; 95% CI, 31.8e36.4%) than for non-Indigenous women (46.5%; 95% CI, 46.0e47.0%; unadjusted incidence rate ratio [IRR], 0.65; 95% CI, 0.60e0.71). This difference remained after adjusting for place of residence, area-level disadvantage, and age group (adjusted IRR, 0.74; 95% CI, 0.68e0.81). However, Indigenous women who had not been followed up within 2months were subsequently more likely to have a clinical investigation than non-Indigenous women (adjusted IRR for 2e4 month interval, 1.21; 95% CI, 1.08e1.36); by 6 months, a similar proportion of Indigenous (62.2%; 95% CI, 59.8e64.6%) and non-Indigenous women (62.8%; 95% CI, 62.2e63.3%) had been followed up. Conclusion(s): Prompt follow-up after a HGA Pap smear finding needs to improve for Indigenous women. Nevertheless, slow follow-up is a smaller contributor to their higher cervical cancer incidence and mortality than their lower participation in cervical screening.Copyright ©2017 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved.
The tobacco industry and Aboriginal and Torres Strait Islander people.
(2012-09-24) Thomas D.P.; Bond L.
The characteristics and reporting quality of research impact case studies: a systematic review.
(2018-11-21) Heyeres M.; Tsey K.; Yang Y.; Yan L.; Jiang H.
Despite the growing expectation that researchers report the impact of their research using a case study approach, systematic reviews of research impact have focused on frameworks, indicators, methods of data collection and assessment rather than impact case studies. Our aim is to provide an overview of the characteristics of published research impact case studies, including translation activities, and their reporting quality. We searched for peer-reviewed impact studies published between 2000 and 2018 using a case study approach and selected 25 suitable papers. We applied descriptive statistics to study characteristics, conducted thematic analysis of research translation activities and assessed reporting quality using the 10-point ISRIA statement. 24 papers reported intermediate impacts, such as advocacy, or the development of statements, tools, or technology. 4 reported on longer-term societal impacts, such as health outcomes and economic return on investment. 7 reported on translation activities. Papers scored well against the ISRIA statement on 5 domains of reporting quality. Weakest scores centred around identification of stakeholder needs and stakeholder involvement, and ethics and conflict of interest. We identified the need for more consistency in reporting through a case study approach, more systematic reporting of translation pathways and greater transparency concerning estimated costs and benefits of the research and its translation and impact assessment. Copyright © 2018 Elsevier Ltd
Strengths-based approaches for quantitative data analysis: a case study using the Australian longitudinal study of Indigenous children.
(2020-10-05) Thurber K.A.; Thandrayen J.; Banks E.; Doery K.; Sedgwick M.; Lovett R.
In Australia and internationally, there are increasing calls for the use of strengths-based methodologies, to counter the dominant deficit discourse that pervades research, policy, and media relating to Indigenous health and wellbeing. However, there is an absence of literature on the practical application of strengths-based approaches to quantitative research. This paper describes and empirically evaluates a set of strategies to support strengths-based quantitative analysis. A case study about Aboriginal and Torres Strait Islander child wellbeing was used to demonstrate approaches to support strengths-based quantitative analysis, in comparison to the dominant deficit approach of identifying risk factors associated with a negative outcome. Data from Wave 8 (2015) of the Australian Longitudinal Study of Indigenous Children were analysed. The Protective Factors Approach is intended to enable identification of factors protective against a negative outcome, and the Positive Outcome Approach is intended to enable identification of factors associated with a positive health outcome. We compared exposure-outcome associations (prevalence ratios and 95% confidence intervals (CIs), calculated using Poisson regression with robust variance) between the strengths-based and deficit approaches. In this case study, application of the strengths-based approaches retains the identification of statistically significant exposure-outcome associations seen with the standard deficit approach. Strengths-based approaches can enable a more positive story to be told, without altering statistical rigour. For Indigenous research, a strengths-based approach better reflects community values and principles, and it is more likely to support positive change than standard pathogenic models. Further research is required to explore the generalisability of these findings.Copyright © 2020 The Author(s)
Restoring children from out-of-home care: insights from an Aboriginal-led community forum.
Newton B.J; Gray P.; Cripps K.; Falster K.; Katz I.; Chiswell K.; Wellington L.; Ardler R.; Frith F.; Jones T.; Kent M.; Tong N.
Restoring children from out-of-home care (OOHC) to their families is the preferred outcome for all children removed by child protection services, yet little is known about how restoration processes are experienced by families and services supporting them. This paper provides important insights about Aboriginal child restoration from 40 practitioners and stakeholders at a community forum led by Aboriginal Community Controlled Organisations in regional New South Wales (NSW), Australia. This is one component of larger Aboriginal-led research, which investigates child protection experiences and pathways to successful restoration in NSW and the data source for this paper. The community forum explored the issues for families navigating family preservation, OOHC and restoration within child protection and legal systems. Findings include the need for a continuum of support for families throughout their engagement with child protection systems and crucially following the removal of their children. Barriers to effective restoration practice included a lack of access to meaningful and ongoing preservation services, insufficient cultural care planning and family finding efforts that are often too late, the pressure on services to support families without adequate capabilities or enough resourcing, the lack of transparency and the complexities in navigating the restoration process, and the lack of culturally informed support for children and their families while children are in care. Implications for policy and practice are discussed. This paper contributes to understanding practice, processes and barriers for restoration, particularly focused on the perspectives of Aboriginal families and communities, with potential insights for practice within Australia and internationally. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Reducing adolescent use of harmful legal products: intermediate effects of a community prevention intervention.
(2010-01-28) Gruenewald P.J.; Johnson K.; Shamblen S.R.; Ogilvie K.A.; Collins D.
Purpose: Preliminary results are presented from a feasibility study of a comprehensive community prevention intervention to reduce the use of inhalants and other harmful legal products (HLPs) among adolescents in three Alaskan frontier communities conducted in 2004-2007. The legal products used to get high include over-the-counter drugs, prescription drugs, and common household products. Community mobilization, environmental and school-based strategies were implemented to reduce access, enhance knowledge of risks, and improve assertiveness and refusal skills. Method(s): Pre- and post-intervention survey data were collected from 5-7th grade students from schools in three communities using standardized instruments to assess knowledge, assertiveness, refusal skills, perceived availability, and intent to use. The intervention consisted of community mobilization and environmental strategies to reduce access to HLPs in the home, at school, and through retail establishments. In addition, the ThinkSmart curriculum was implemented in classrooms among 5th grade students to increase the knowledge of harmful effects of HLPs and improve the refusal skills. Data were analyzed using hierarchical linear models that enable corrections for correlated measurement error. Result(s): Significant increases in knowledge of harms related to HLP use and decreases in perceived availability of HLP products were observed. The environmental strategies were particularly effective in reducing the perceived availability of HLPs among 6th and 7th graders. Discussion(s): Although limited by the absence of randomized control groups in this preliminary study design, the results of this study provide encouragement to pursue mixed strategies for the reduction of HLP use among young people in Alaskan frontier communities.
Psychiatric illness and the risk of reoffending: recurrent event analysis for an Australian birth cohort.
(2023-07-29) Ogilvie J.M.; Tzoumakis S.; Thompson C.; Allard T.; Dennison S.; Kisely S.; Stewart A.
Background: Psychiatric illness is a well-established risk factor for criminal justice system involvement, but less is known about the relationships between specific psychiatric illnesses and reoffending. Research typically examines reoffending as a single discrete event. We examined the relationship between different psychiatric disorders and types of reoffending while accounting for multiple reoffending events over time. Method(s): Data were drawn from a population cohort of 83,039 individuals born in Queensland, Australia, in 1983 and 1984 and followed to age 29-31 years. Psychiatric diagnoses were drawn from inpatient health records and offending information was drawn from court records. Descriptive and recurrent event survival analyses were conducted to examine the association between psychiatric disorders and reoffending. Result(s): The cohort included 26,651 individuals with at least one proven offence, with 3,580 (13.4%) of these individuals also having a psychiatric disorder. Individuals with any psychiatric disorder were more likely to reoffend compared to those without a disorder (73.1% vs. 56.0%). Associations between psychiatric disorders and reoffending varied across age. Individuals with a psychiatric disorder only started to accumulate more reoffending events from ~ 27 years, which accelerated up to age 31 years. There were both specificity and common effects in the associations between different psychiatric disorders and types of reoffending. Conclusion(s): Findings demonstrate the complexity and temporal dependency of the relationship between psychiatric illness and reoffending. These results reveal the heterogeneity present among individuals who experience psychiatric illness and contact with the justice system, with implications for intervention delivery, particularly for those with substance use disorders.Copyright © 2023, The Author(s).
Preparing the genetic counseling workforce for the future in Australasia.
(2021-11-11) McEwen A.; Jacobs C.
Current genetic counseling students will graduate into a workforce involving more opportunities, diversity, and uncertainty than any previous generation. Preparing the future genetic counseling workforce is a dynamic challenge, both for the profession and for educators. The dominance of the medical model in the state funded Australian healthcare system creates a power imbalance between doctors and other health professionals. As a result, professional regulation to protect the public from harm in line with the United States, the UK, and Canada only became mandatory in 2019. Professional regulation has the additional benefit of enhancing professional standing and autonomy, enabling genetic counselors to help shape the future of genetic health care in Australia and New Zealand. Within this rapidly evolving environment, we are establishing a new Masters' program and building a discipline of genetic counseling, working alongside other allied health professionals. Our program involves synchronous and asynchronous learning, greater accessibility, flexibility and, as we have learned in 2020, reduction in disruption during a global pandemic. In this program, we foreground the inherent knowledge, skills, and values of genetic counseling, shifting the focus from provision of genetic and genomic tests, to educating competent, person-centered, research enabled and culturally safe genetic counselors. As educators, we have a responsibility to prepare students to embrace the uncertainties, challenges, and potential of the genomic era, to seize the many possibilities that lie ahead, and to expand their thinking and vision. We ask our students to be courageous, to step into a deep exploration of their own identity, beliefs, understanding, and experiences of oppression, power, and privilege. We are pushing boundaries, and challenging ourselves and our students to remain always open to possibilities. Equipping students with open eyes and listening ears may be the single most important thing we can do to prepare the genetic counseling workforce of the future to provide the best possible care.Copyright © 2020 National Society of Genetic Counselors.
Obesity and its association with sociodemographic factors, health behaviours and health status among Aboriginal and non-Aboriginal adults in New South Wales, Australia.
(2020-10-07) Thurber K.A.; Joshy G.; Korda R.; Eades S.J.; Wade V.; Bambrick H.; Liu B.; Banks E.
Background: High body mass index (BMI) is the second leading contributor to Australia's burden of disease and is particularly prevalent among Aboriginal peoples. This paper aims to provide insight into factors relating to obesity among Aboriginal adults and Aboriginal-non-Aboriginal differences. Methods: Cross-sectional analysis of data from the 45 and Up Study, comparing obesity (BMI >=30kg/m2) prevalence and risk factors among 1515 Aboriginal and 213301 non-Aboriginal adults in New South Wales. Age-sex-adjusted prevalence ratios (PRs) for obesity by sociodemographic factors, health behaviours and health status were estimated (multivariable log-binomial regression) for Aboriginal and non-Aboriginal participants separately. We quantified the extent to which key factors (physical activity, screen time, education, remoteness, area-level disadvantage) accounted for any excess Aboriginal obesity prevalence. Results: Obesity prevalence was 39% among Aboriginal and 22% among non-Aboriginal participants (PR=1.65, 95% CI 1.55 to 1.76). Risk factors for obesity were generally similar for Aboriginal and non-Aboriginal participants and included individual-level and area-level disadvantage, physical inactivity, and poor physical and mental health, with steeper gradients observed among non-Aboriginal participants for some factors (Pinteraction <0.05). Many risk factors were more common among Aboriginal versus non-Aboriginal participants; key factors accounted for >40% of the excess Aboriginal obesity prevalence. Conclusions: A substantial proportion of the excess obesity prevalence among Aboriginal versus non-Aboriginal participants was explained by physical activity, screen time, education, remoteness and area-level disadvantage. Socioeconomic and health behaviour factors are potential targets for promoting healthy BMI, but these must be considered within the context of upstream social and cultural factors. Adults with health needs and disability require particular attention.Copyright © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
One Health and Australian Aboriginal and Torres Strait Islander communities: a One Health pilot study.
(2023-08-21) Riley T.; Cumming B.; Thandrayen J.; Meredith A.; Anderson N.E.; Lovett R.
Many Aboriginal and Torres Strait Islander communities face barriers in accessing animal healthcare and are exposed to disproportionate environmental health exposures leading to increased risk of disease. A One Health approach has been promoted to address public health risks and improve human, animal, and environmental health outcomes in communities. We undertook a pilot One Health study in Aboriginal and Torres Strait Islander communities in Queensland collecting animal, human, and environmental health data from 82 households. We performed a descriptive analysis and assessed the association between human and environmental health exposures and animal health outcomes. Most households were not crowded (82.9%) but did report a high level of environmental health concerns (86.6%). The majority of households owned cats and dogs (81.7%), with most animals assessed as healthy. There was no association between human and environmental health exposures and animal health outcomes. As most households experienced concerns regarding housing conditions, environmental health programs should prioritise improving household factors. There was also strong support for animal healthcare (including access to medicines and veterinarians, education programs and population management), indicating that a One Health approach is desired by communities.Copyright © 2023 by the authors.
One Health in Indigenous communities: a critical review of the evidence.
(2022-03-28) Riley T.; Anderson N.E.; Lovett R.; Meredith A.; Cumming B.; Thandrayen J.
Indigenous populations around the world face disproportionately high rates of disease related to the environment and animals. One Health is a concept that has been used effectively to understand and address these health risks. One Health refers to the relationships and interdependencies between animal, human, and environmental health and is an emerging research field that aligns with Indigenous views of health. To understand the applicability of One Health in Indigenous communities, a critical review was undertaken to investigate evidence of One Health research in Indigenous communities internationally, assess the strength of evidence, and understand what gaps are present. This review included the appraisal of twenty-four studies based in five regions: Canada, Africa, Australia, South America, and Central America. The review found that there is a need for studies of high strength, with rigorous methods, local leadership, and active involvement of Indigenous viewpoints, to be undertaken in Indigenous communities internationally that focus on One Health. It highlights the need to further consider Indigenous viewpoints in research to reduce limitations, increase effectiveness of findings, consider appropriateness of recommendations, and benefit communities.Copyright © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Learning from alcohol (policy) reforms in the Northern Territory (LEARNT): protocol for a mixed-methods study examining the impacts of the banned drinker register.
(2022-05-20) Miller P.; Coomber K.; Smith J.; Livingston M.; Stevens M.; Guthridge S.; Room R.; Wright C.J.C.; Rung D.; Clifford S.; Baldwin R.; Das S.; Paradies Y.; Scott D.; Griffiths K.E.; Farmer C.; Mayshak R.; Silver B.; Moore S.; Mack J.; Mithen V.; Dyall D.; Ward J.; Boffa J.; Chikritzhs T.
Introduction The Banned Drinker Register (BDR) was reintroduced in the Northern Territory (NT) in September 2017. The BDR is a supply reduction measure and involves placing people who consume alcohol at harmful levels on a register prohibiting the purchase, possession and consumption of alcohol. The current study aims to evaluate the impacts of the reintroduction of the BDR, in the context of other major alcohol policy initiatives introduced across the NT such as Police Auxiliary Liquor Inspectors and a minimum unit price for alcohol of US$1.30 per standard drink. Methods and analyses The Learning from Alcohol (policy) Reforms in the Northern Territory project will use a mixed-methods approach and contain four major components: epidemiological analysis of trends over time (outcomes include health, justice and social welfare data); individual-level data linkage including those on the BDR (outcomes include health and justice data); qualitative interviews with key stakeholders in the NT (n>=50); and qualitative interviews among people who are, or were previously, on the BDR, as well as the families and communities connected to those on the BDR (n=150). The impacts of the BDR on epidemiological data will be examined using time series analysis. Linked data will use generalised mixed models to analyse the relationship between outcomes and exposures, utilising appropriate distributions. Qualitative data will be analysed using thematic analysis. Ethics and dissemination Ethics approvals have been obtained from NT Department of Health and Menzies School of Health Research Human Research Ethics Committee (HREC), Central Australia HREC and Deakin University HREC. In addition to peer-reviewed publications, we will report our findings to key organisational, policy, government and community stakeholders via conferences, briefings and lay summaries.Copyright © 2022 BMJ Publishing Group. All rights reserved.
Indigenous participation in an informal national Indigenous health policy network.
(2011-10-04) Lock M.J.; Thomas D.P.; Anderson I.P.; Pattison P.
Objective. To determine and describe the features of Indigenous participation in an informal national Indigenous health policy network. Design. A questionnaire was administered during 200304. Through a snowball nomination process a total of 227 influential persons were identified. Of these, 173 received surveys of which 44 were returned, a return rate of 25%. Outcome measures. These data were analysed to detect the existence of network groups; measure the degree of group interconnectivity; and measure the characteristics of bonds between influential persons. Demographic information was used to characterise the network and its groups. Results. Indigenous people were integral to the network due to their high representation, their distribution throughout the 16 groups, and the interconnections between the groups. The network was demographically diverse and multiple relational variables were needed to characterise it. Indigenous and non-Indigenous people had strong ties in this network. Conclusion. Social network methods made visible an informal network where Indigenous and non-Indigenous people relate in a complex socio-political environment to influence national Indigenous health policy. What is known about the topic? The participation of Indigenous people is acknowledged as important in health, but there is criticism of the lack of real opportunities for Indigenous people to participate in national Indigenous health policy processes. What does this paper add? This research reveals the presence of an informal network of influential persons. It demonstrates a way to investigate the concept of participation through social network analytic techniques. It reveals that Indigenous people are fundamental to an informal network that influences national health policy processes. What are the implications for practitioners? Practitioners can become more aware of their place in informal networks of influence and of their capacity to exercise personal influence in national policy decisions based on advice drawn from their informal networks. © 2011 AHHA.
Indigenous Australians with non-small cell lung cancer or cervical cancer receive suboptimal treatment.
(2017-11-07) Whop L.J.; Bernardes C.M.; Kondalsamy-Chennakesavan S.; Darshan D.; Chetty N.; Moore S.P.; Garvey G.; Walpole E.; Baade P.; Valery P.C.
Background: Lung cancer and cervical cancer are higher in incidence for Indigenous Australians and survival is worse compared with non-Indigenous Australians. Here we aim to determine if being Indigenous and/or other factors are associated with patients receiving "suboptimal treatment" compared to "optimal treatment" according to clinical guidelines for two cancer types. Method(s): Data were collected from hospital medical records for Indigenous adults diagnosed with cervical cancer and non-small cell lung cancer (NSCLC) and a frequency-matched comparison group of non-Indigenous patients in the Queensland Cancer Registry between January 1998 and December 2004. The two cancer types were analyzed separately. Result(s): A total of 105 women with cervical cancer were included in the study, 56 of whom were Indigenous. Indigenous women had higher odds of not receiving optimal treatment according to clinical guidelines (unadjusted OR 7.1; 95% CI, 1.5-33.3), even after adjusting for stage (OR 5.7; 95% CI, 1.2-27.3). Of 225 patients with NSCLC, 198 patients (56% Indigenous) had sufficient information available to be analyzed. The odds of receiving suboptimal treatment were significantly higher for Indigenous compared to non-Indigenous NSCLC patients (unadjusted OR 1.9; 95% CI, 1.0-3.6) and remained significant after adjusting for stage, comorbidity and age (adjusted OR 2.1; 95% CI, 1.1-4.1). Conclusion(s): The monitoring of treatment patterns and appraisal against guidelines can provide valuable evidence of inequity in cancer treatment. We found that Indigenous people with lung cancer or cervical cancer received suboptimal treatment, reinforcing the need for urgent action to reduce the impact of these two cancer types on Indigenous people. Copyright © 2016 John Wiley & Sons Australia, Ltd

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