Welcome to the Lowitja Institute Repository

This institutional research repository is for the work of the Lowitja Institute, Australia’s national Aboriginal and Torres Strait Research Institute. Our work focuses on the health and wellbeing of Aboriginal and Torres Strait Islander peoples and Indigenous peoples across the globe. This Repository tracks the research outputs of Lowitja Institute employees, funded researchers and scholars as well as showcases community-led Aboriginal and Torres Strait Islander health research.

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Recent Submissions

Truth-telling is required for health equity for aboriginal peoples: A qualitative study.
(2025-04-19) D'Costa I.; Russell R.; Adams K.
Background: The World Health Assembly has called for a Global Action Plan to address health inequities imposed upon Indigenous peoples. In seeking equity, Aboriginal peoples and allies have called for truth-telling about colonisation and its relation to healthcare. Australian healthcare, largely based on the biomedical model, is inadequate in terms of design, delivery, and access for Aboriginal peoples. Healthcare employees are known to contribute to health inequities. Purpose: This study explores non-Indigenous healthcare employee perceptions and experiences of engaging with Aboriginal peoples. Methods: Forty-nine health professionals from an Australian hospital participated in qualitative interviews. Interviews were audio-recorded, and data analysed with reflexive thematic analysis. Interviewees volunteered for the study and were first recruited in January 2020. The study is not registered. Results: Four themes were identified, including perceptions of: colonisation, Aboriginal peoples and knowledges, racism toward Aboriginal people, and healthcare inequities imposed upon Aboriginal people. Many participants were oblivious to how colonisation and racism create present healthcare inequities. This limited understanding was a consequence of feelings of distress and subsequent disengagement with the history of colonisation. Conclusions: Healthcare education requires better truth-telling methods to achieve health equity. We suggest trials of collaborative modes of education from arts and humanities that simultaneously recognise continuing colonial ideology and promote antiracism. Crucially, as the World Health Assembly notes, from design to implementation, these strategies must foreground and involve Aboriginal peoples, and deeper understanding of what it is to be an Indigenous ally. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Learning together: A participatory evaluation of the Learning Language and Loving It program in an Aboriginal community-led kindergarten.
(2025-08-21) Stark H.; Smeaton P.; Kennedy P.; Lammonde C.; Stewart J.; Williams S.; Carius K.; Bennett-Payne B.; Duncan T.
High-quality early childhood education requires ongoing professional learning for educators, yet Aboriginal and Torres Strait Islander educators face barriers to accessing culturally responsive professional development. This study evaluated the Hanen Center Learning Language and Loving It TM (LLLI) professional learning program in an Aboriginal community-led kindergarten in a regional Australian city. Using a mixed-methods single case study design with participatory evaluation methodology, we examined educator-child interactions before, immediately after, and eight months following program completion. Participants included Aboriginal and non-Indigenous educators (n = 7), a speech pathologist facilitator, and university researcher working collaboratively as co-researchers. The LLLI program consisted of eight group training sessions and individual video coaching delivered over six months. Data collection included focus groups, individual interviews, and validated observational measures: the Classroom Assessment Scoring System Pre-K (CLASS) and Teacher Interactions and Language Rating Scale (TILR). Thematic analysis revealed three key themes: an affirming and transformative professional learning experience, fostering a responsive professional learning environment, and building connections and changing expectations. Quantitative results showed sustained improvements in educator-child interactions, with large effect sizes maintained at eight-month follow-up, particularly in Instructional Support (Cohen's D = 1.37) and Emotional Support domains (Cohen's D = 1.81). Participants identified that program effectiveness was influenced by trust, familiar learning spaces, and existing relationships between facilitators and participants. These findings demonstrate that professional learning programs can be delivered with fidelity while maintaining the flexibility required for culturally responsive implementation. The study provides insights into supporting Aboriginal educators through place-based, relationship-centered professional development approaches. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
The landscape of supportive care needs among prostate cancer patients in New Zealand: A cross-ethnic analysis.
(2025-02-21) Xiao H.; Baxter D.G.; Liu L.; Hoeta T.; Wibowo E.
Background: Prostate cancer (PCa) is a significant health burden within New Zealand (NZ). Survival gains from prostate cancer have created a shift in focus from survival towards quality of life (QoL) and supportive care during extended survivorship. Method: We launched a nation-wide cross-sectional survey and recruited three cohorts of 1000 men with prostate cancer (men diagnosed with prostate cancer within 1 year, between 1 and 3 years, and between 3 and 5 years) as well as an additional Maori men group (N = 4000 in total). The survey instruments measured quality of life, supportive care needs, and care service utilization. Results: Analysis of 1075 responses revealed that Maori men experienced lower quality of life and reported greater unmet supportive care needs. Information and psychology needs were mostly reported in both Maori and non- Maori groups. Key predictors of these needs included mental health conditions, hormonal imbalances, and employment status. Conclusion: The study highlights significant ethnic disparities in the supportive care needs of New Zealand prostate cancer survivors (PCS), emphasizing the necessity for tailored, culturally sensitive healthcare interventions. Addressing the complex determinants of these needs is crucial for enhancing the well-being of all PCS. Implications for Cancer Survivors: Actively seeking health information and mental health counselling would significantly benefit PCS by reducing unmet supportive care needs and improving overall quality of life. This approach encourages survivors to take an active role in their healthcare, potentially leading to better health outcomes and enhanced well-being. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Truth telling and the "lead splinter": Aboriginal elders' perspectives on community service provision and intergenerational trauma.
(2025-10-15) Caddy J.; Gringart E.; Garvey D.
This article is based on PhD research aimed at improving community services for remote Aboriginal people with intergenerational trauma. It focuses on the role that Yamatji Aboriginal Elders played in cocreating a framework to enhance service provision for Aboriginal clients and the importance of local truth telling in this endeavour. Elders specified that local truth telling was essential in building shared understandings of healing from intergenerational trauma between Aboriginal people and community service providers. The characterisation of intergenerational trauma as a "lead splinter", continually poisoning the wellbeing of Aboriginal people provided an illustration of trauma and the complexities of facilitating healing. The findings emphasise the need for community service providers to undertake truth telling to understand and resolve these key challenges. This engagement facilitates the decolonisation of social work practice through deeper knowledge of local history, incorporation of Aboriginal perspectives of wellbeing, and the development of culturally based approaches to social work with people with intergenerational trauma.IMPLICATIONSUnderstanding historical trauma and intergenerational trauma can inform meaningful social work practice with Aboriginal service users.Decolonising community services and social work practices needs to include an emphasis on local truth telling. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Trauma-informed primary healthcare for parents: Multidisciplinary experiences in rural service implementation.
(2023-12-17) Reid C.; Smullen F.; Bennetts S.K.; Amir L.H.; Chamberlain C.
Trauma-informed approaches to service delivery increase awareness of the pervasiveness of trauma exposure and acknowledge the lifelong effects of traumatic stress on health and wellbeing. This study explored workforce experiences of trauma-informed primary healthcare for parents. A face-to-face workshop was conducted with 14 Victorian rural professionals in 2021. Local workforce survey results (n = 63) about trauma-informed care were presented to the group (50% social workers) and they discussed strategies for system implementation. Content analysis was used to develop four categories from the transcribed workshop discussion: (1) primary healthcare understanding of complex trauma; (2) primary healthcare responses to parents; (3) trauma-informed care training; and (4) community and relational strategies to foster trauma-informed care. Our findings highlighted that structural barriers relating to resource control and restrictive program design negatively impact trauma-informed approaches. In contrast, trauma-informed service delivery is enabled by collaboration and building relationships between clients, the workforce, and organisations. In discussing these findings, we draw upon notions of power: namely, discursive, epistemic, and material power, which affect equity. To ensure the client's voice is prioritised when planning trauma-informed care, we recommend the integration of local knowledge and the embedding of community-based strategies throughout all implementation processes. (PsycInfo Database Record (c) 2025 APA, all rights reserved)