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Vance A, McGaw J, O'Meara A, Gone JP, Eades S. Exploring the association of Indigeneity, social adversity status and externalizing symptoms in children and adolescents. Aust N Z J Psychiatry 2024:48674241246441. [PMID: 38642027 DOI: 10.1177/00048674241246441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2024]
Abstract
OBJECTIVE The relationship between Indigeneity, social adversity status and externalizing symptoms is complex and unclear. This study investigates how Indigeneity, social adversity status and externalizing symptoms are related in young people. METHODS A total of 132 Indigenous and 247 non-Indigenous young people aged 6-16 years were recruited from a hospital mental health outpatient service. Normality plots with statistics for social adversity status and parent-reported externalizing symptoms were completed for the two groups, matched for age, gender, mental disorder symptom severity, symptom-linked distress and impairment. Standard multiple regression was used to examine how Indigeneity moderates the relationship between social adversity status and parent-reported externalizing symptoms. A scatterplot investigated the association between Indigeneity and social adversity status in young people with parent-reported externalizing symptoms. RESULTS The distributions of the two groups and (1) social adversity status and (2) parent -reported externalizing symptoms were non-normal but acceptable for a moderator analysis. Indigeneity and social adversity status made independent significant positive contributions to externalizing symptoms. In contrast the interaction between Indigeneity and social adversity status made a nonsignificant negative trend to externalizing symptoms. A scatterplot revealed Indigeneity moderated the link between social adversity status and externalizing symptoms. CONCLUSIONS High social adversity status is linked to externalizing symptoms in non-Indigenous young people but despite higher social adversity, Indigenous young people don't necessarily externalize. Potential protective resilience factors for externalizing symptoms in the Indigenous young people need to be ascertained and nurtured. Future systematic investigations of the contribution of these protective factors to Indigenous referral pathways and management are needed. It is also crucial that increased social adversity status is addressed and managed in all young people, regardless of Indigeneity.
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Affiliation(s)
- Alasdair Vance
- Academic Child Psychiatry Unit and Developmental Neuropsychiatry Program, The Royal Children's Hospital, The University of Melbourne, Parkville, VIC, Australia
- Wadja Aboriginal Family Place, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Janet McGaw
- Faculty of Architecture, Building and Planning, The University of Melbourne, Parkville, VIC, Australia
| | - Angel O'Meara
- Wadja Aboriginal Family Place, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Joseph P Gone
- Department of Anthropology and Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Cambridge, MA, USA
| | - Sandra Eades
- Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Population and Global Health, Parkville, VIC, Australia
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Thapa S, Gibbs P, Ross N, Newman J, Allan J, Dalton H, Mahmood S, Kalinna BH, Ross AG. Are adverse childhood experiences (ACEs) the root cause of the Aboriginal health gap in Australia? BMJ Glob Health 2024; 9:e014901. [PMID: 38442985 DOI: 10.1136/bmjgh-2023-014901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/04/2024] [Indexed: 03/07/2024] Open
Affiliation(s)
- Subash Thapa
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Peter Gibbs
- Regional Enterprise Development Institute (REDI.E), Dubbo, New South Wales, Australia
| | - Nancy Ross
- School of Social Work, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jamie Newman
- Orange Aboriginal Medical Service, Orange, New South Wales, Australia
| | - Julaine Allan
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Hazel Dalton
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Shakeel Mahmood
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Bernd H Kalinna
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Allen G Ross
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
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Vance A, McGaw J, Winther J, White S, Gone JP, Eades S. Country and community vs poverty and conflict: Teasing apart the key demographic and psychosocial resilience and risk factors for Indigenous clinic-referred children and adolescents. Aust N Z J Psychiatry 2023; 57:1538-1546. [PMID: 37480284 PMCID: PMC10666524 DOI: 10.1177/00048674231187315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
OBJECTIVE Indigenous young people are known to have adverse demographic and psychosocial factors affecting worse mental health outcomes and some household factors aiding resilience. In Australia, there has been no exploration of these factors in clinically referred Indigenous young people assessed in a culturally appropriate way. METHODS A total of 113 Indigenous children and adolescents, 217 non-Indigenous young people, age, gender, mental disorder symptom severity, symptom-linked distress and impairment matched, and 112 typically developing participants, age- and gender-matched were recruited. Cultural validity and reliability of the impairing symptoms in Indigenous young people were determined. Key demographic and psychosocial factors were compared across the three groups. RESULTS The Indigenous clinical group differed significantly from the other two groups that did not differ on three possibly protective measures examined. Key demographic and psychosocial risk factors in the Indigenous group differed significantly from the non-Indigenous clinical group which in turn differed from the typically developing participants. The three groups exhibited a progressively increased magnitude of difference. CONCLUSIONS It remains imperative to nurture features that provide protection and enhance resilience for Indigenous young people and their communities. Indigenous status is linked to significant demographic and psychosocial disadvantage over and above that conferred by clinical impairment and its management. It is crucial that these features are managed and/or advocated for with those demographic and psychosocial factors of the greatest magnitude dealt with first. Future systematic investigations of the contribution of these key factors to mental health referral pathways, assessment and management are needed.
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Affiliation(s)
- Alasdair Vance
- Academic Child Psychiatry Unit and Developmental Neuropsychiatry Program, The Royal Children’s Hospital, The University of Melbourne, Parkville, VIC, Australia
- The Wadja Aboriginal Family Place, The Royal Children’s Hospital, Parkville, VIC, Australia
| | - Janet McGaw
- Faculty of Architecture, Building and Planning, The University of Melbourne, Parkville, VIC, Australia
| | - Jo Winther
- Academic Child Psychiatry Unit and Developmental Neuropsychiatry Program, The Royal Children’s Hospital, The University of Melbourne, Parkville, VIC, Australia
- The Wadja Aboriginal Family Place, The Royal Children’s Hospital, Parkville, VIC, Australia
| | - Selena White
- The Wadja Aboriginal Family Place, The Royal Children’s Hospital, Parkville, VIC, Australia
| | - Joseph P Gone
- Department of Anthropology, Harvard University, Cambridge, MA, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Sandra Eades
- School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia
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Adane AA, Shepherd CC, Reibel T, Ayano G, Marriott R. The perinatal and childhood outcomes of children born to Indigenous women with mental health problems: A scoping review. Midwifery 2023; 125:103779. [PMID: 37562160 DOI: 10.1016/j.midw.2023.103779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/23/2023] [Accepted: 08/01/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE Maternal mental health problems are common during the perinatal period and have been associated with several negative outcomes in children. However, few studies have examined the associations between maternal mental health problems and offspring outcomes among Indigenous people, and the findings across these studies have been inconsistent. This scoping review examined the birth and childhood (≤12 years) health and development outcomes of the children of Indigenous women with mental health problems. METHODS A scoping review was conducted following the methodological framework developed by Arksey and O'Malley and based on the PRISMA-ScR guidelines. Eight databases were searched electronically for studies examining the associations between any perinatal maternal mental health problems and birth and childhood outcomes among the Indigenous populations of Australia, Canada, New Zealand, and the USA. Two authors reviewed studies for inclusion. A narrative synthesis approach was adopted. RESULTS Of 2,836 records identified, 10 were eligible. One of three studies evaluating maternal depression and anxiety problems found a negative (adverse) association with birth and childhood behavioural outcomes. Six of seven studies that examined the associations between maternal substance use disorder (mainly alcohol use disorder) and several birth and childhood outcomes found at least one negative association. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Maternal substance use disorder appears to be associated with adverse birth and childhood outcomes among some Indigenous populations. However, there is preliminary evidence for the other common maternal mental health problems. Further research is critically required to draw definitive conclusions regarding the impact of maternal mental health problems on the birth and childhood outcomes.
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Affiliation(s)
- Akilew A Adane
- Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia; Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia.
| | - Carrington Cj Shepherd
- Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia; Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia; Curtin Medical School, Curtin University, Bentley, WA, Australia
| | - Tracy Reibel
- Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia
| | - Getinet Ayano
- School of Indigenous Studies, The University of Western Australia, Crawley, WA, Australia; School of Population Health, Curtin University, Bentley, WA, Australia
| | - Rhonda Marriott
- Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia
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Young SL, Steane SE, Kent NL, Reid N, Gallo LA, Moritz KM. Prevalence and Patterns of Prenatal Alcohol Exposure in Australian Cohort and Cross-Sectional Studies: A Systematic Review of Data Collection Approaches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13144. [PMID: 36293721 PMCID: PMC9603223 DOI: 10.3390/ijerph192013144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
This study sought to determine data collection approaches in Australian cohort studies and explore the potential impact on reported prenatal alcohol exposure (PAE) prevalence and patterns. Inclusion criteria were that studies related to a general Australian antenatal population where PAE was assessed and reported. Studies were excluded if they were not peer reviewed, examined the prevalence of PAE in pregnancies complicated by alcohol-use disorders, or were published in a language other than English. A systematic search of five electronic databases (PubMed, Embase, CINAHL, Web of Science, and Scopus) was conducted. Risk of bias was assessed using the Effective Public Health Practice Project quality assessment tool. Results were synthesised using MetaXL. Data from 16 separate birth cohorts (n = 78 articles) were included. Included cohorts were either general cohorts that included alcohol as a variable or alcohol-focused cohorts that were designed with a primary focus on PAE. PAE prevalence was estimated as 48% (95% CI: 38 to 57%). When subgroup analysis was performed, estimates of PAE prevalence when self-administered surveys and interviews were used for data collection were 53% (95% CI: 41% to 64%) and 43% (95% CI: 28% to 59%), respectively. Use of trained assessors was an influencing factor of the prevalence estimates when data were collected via interview. Alcohol-focused studies reported higher prevalence of PAE, regardless of method of survey administration. Where interviewer training is not possible, self-administered questionnaires will likely provide the most reliable PAE estimates. No funding sources are relevant to mention. Review was registered with PROSPERO (CRD42020204853).
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Affiliation(s)
- Sophia L. Young
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Sarah E. Steane
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Nykola L. Kent
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Natasha Reid
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
| | - Linda A. Gallo
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Petrie, QLD 4502, Australia
| | - Karen M. Moritz
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St. Lucia, QLD 4072, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia
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Radford A, Toombs E, Zugic K, Boles K, Lund J, Mushquash CJ. Examining Adverse Childhood Experiences (ACEs) within Indigenous Populations: a Systematic Review. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:401-421. [PMID: 35600513 PMCID: PMC9120316 DOI: 10.1007/s40653-021-00393-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/24/2021] [Indexed: 06/03/2023]
Abstract
Health concerns in Indigenous people are often greater in comparison to those in non-Indigenous populations, including increased rates of chronic diseases and mental health concerns. Adverse childhood experiences (ACEs) may be an explanatory variable for such heightened rates of mental and physical health difficulties for Indigenous populations as these communities have experienced a lack of adequate health care due to remoteness, historical traumas, cultural insensitivity, racism, and perpetuating systemic discrimination. To date, relatively few studies have examined ACEs within an Indigenous population and their relevance to both physical and mental health outcomes. The present study explored existing ACE literature relevant to Indigenous populations and mental or physical health outcomes by retrieving and organizing available ACE literature. A systematic review was conducted using 14 electronic databases of peer-reviewed literature and 18 grey literature databases. Twenty-one publications investigating general health outcomes and prevalence of ACEs met eligibility criteria. ACEs were reported to be higher in Indigenous populations when compared to non-Indigenous population. Higher ACE scores for Indigenous participants were associated with increased rates of suicidality and psychological distress. Protective factors to reduce the impact of ACEs were cultural identity and connectedness, education, social support, and psychological resilience. Future research may further explore the relationship between ACE scores and protective factors, varying prevalence within specific sub-populations, and consistent reporting of outcomes across studies. Ongoing research has the potential to clarify existing dose-response relationships between early traumatic experiences and current health disparities experienced within some Indigenous communities.
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Affiliation(s)
- Abbey Radford
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
| | - Elaine Toombs
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON Canada
| | - Katie Zugic
- Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON Canada
| | - Kara Boles
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
| | - Jessie Lund
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
| | - Christopher J. Mushquash
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON Canada
- Northern Ontario School of Medicine (NOSM), Lakehead University, Thunder Bay, ON Canada
- Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON Canada
- Thunder Bay Regional Health Research Institute, Thunder Bay, ON Canada
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English M, Wallace L, Evans J, Diamond S, Caperchione CM. The impact of sport and physical activity programs on the mental health and social and emotional wellbeing of young Aboriginal and Torres Strait Islander Australians: A systematic review. Prev Med Rep 2022; 25:101676. [PMID: 35127355 PMCID: PMC8800038 DOI: 10.1016/j.pmedr.2021.101676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/19/2021] [Accepted: 12/22/2021] [Indexed: 11/22/2022] Open
Abstract
This review aimed to identify and assess existing evidence of the impact of sport and physical activity programs on mental health and social and emotional wellbeing outcomes within young Aboriginal and Torres Strait Islander people. The review also aimed to highlight limitations of current practice within the research area. A systematic search of literature was undertaken on three peer-reviewed databases (PsycINFO, MEDLINE and SPORTSDiscus) and grey literature from January to March 2021. Studies were included if they described a sport and physical activity program for young (10-24 years) Aboriginal and Torres Strait Islander people and reported mental health or social and emotional wellbeing outcomes. Seventeen studies were selected for this review. Within these studies, the most commonly reported outcomes were related to psychosocial development (N = 12) and a sense of connectedness (N = 12). Mental illness related outcomes (N = 1) were rarely reported, as were substance use (N = 2) and social and emotional literacy (N = 1). Promising outcomes included increased connection to culture, self-esteem and confidence. Nonetheless, due to indirectness and suboptimal study design the precise impact on these outcomes could not be determined. A relevant evidence base is emerging on the impact sport and physical activity programs have on the mental health and social and emotional wellbeing of young Aboriginal and Torres Strait Islander people. However, further research that utilises robust, culturally appropriate methodologies and tools needs to be undertaken before the effects of sport and physical activity programs can reliably be discerned.
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Affiliation(s)
- Madeleine English
- School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology, Moore Park, Sydney, Australia
| | - Lee Wallace
- School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology, Moore Park, Sydney, Australia
| | - John Evans
- School of Public Health, University of Technology, Broadway, Sydney, Australia
| | - Samantha Diamond
- School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology, Moore Park, Sydney, Australia
| | - Cristina M. Caperchione
- School of Sport, Exercise and Rehabilitation, Human Performance Research Centre, University of Technology, Moore Park, Sydney, Australia
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Abstract
AIMS Limited information exists about the prevalence of psychiatric illness for Indigenous Australians. This study examines the prevalence of diagnosed psychiatric disorders in Indigenous Australians and compares this to non-Indigenous Australians. The aims were to: (1) determine prevalence rates for psychiatric diagnoses for Indigenous Australians admitted to hospital; and (2) examine whether the profile of psychiatric diagnoses for Indigenous Australians was different compared with non-Indigenous Australians. METHODS A birth cohort design was adopted, with the population consisting of 45 141 individuals born in the Australian State of Queensland in 1990 (6.3% Indigenous). Linked administrative data from Queensland Health hospital admissions were used to identify psychiatric diagnoses from age 4/5 to 23/24 years. Crude lifetime prevalence rates of psychiatric diagnoses for Indigenous and non-Indigenous individuals were derived from the hospital admissions data. The cumulative incidence of psychiatric diagnoses was modelled separately for Indigenous and non-Indigenous individuals. Logistic regression was used to model differences between Indigenous and non-Indigenous psychiatric presentations while controlling for sociodemographic characteristics. RESULTS There were 2783 (6.2%) individuals in the cohort with a diagnosed psychiatric disorder from a hospital admission. The prevalence of any psychiatric diagnosis at age 23/24 years was 17.2% (491) for Indigenous Australians compared with 5.4% (2292) for non-Indigenous Australians. Indigenous individuals were diagnosed earlier, with overrepresentation in psychiatric illness becoming more pronounced with age. Indigenous individuals were overrepresented in almost all categories of psychiatric disorder and this was most pronounced for substance use disorders (SUDs) (12.2 v. 2.6% of Indigenous and non-Indigenous individuals, respectively). Differences between Indigenous and non-Indigenous Australians in the likelihood of psychiatric disorders were not statistically significant after controlling for sociodemographic characteristics, except for SUDs. CONCLUSIONS There is significant inequality in psychiatric morbidity between Indigenous and non-Indigenous Australians across most forms of psychiatric illness that is evident from an early age and becomes more pronounced with age. SUDs are particularly prevalent, highlighting the importance of appropriate interventions to prevent and address these problems. Inequalities in mental health may be driven by socioeconomic disadvantage experienced by Indigenous individuals.
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Burt A, Mitchison D, Doyle K, Hay P. Eating disorders amongst Aboriginal and Torres Strait Islander Australians: a scoping review. J Eat Disord 2020; 8:73. [PMID: 33292747 PMCID: PMC7708121 DOI: 10.1186/s40337-020-00346-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/23/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander Australians (Indigenous Australians) have poorer mental health compared to other Australians. Yet, there is a lack of research into mental disorders among this population, especially for eating disorders (ED), which are amongst the most lethal and debilitating mental disorders. AIM We aimed to answer 2 questions: 1. What is the volume and content of literature on ED among Indigenous Australians? 2. Has a screening or diagnostic tool/instrument been developed for the assessment of ED amongst Indigenous Australians? METHOD We conducted a scoping review of electronic databases (Pubmeb, Embase, PsychInfo, Proquest, Cochrane Library, Indigenous HealtInfoNet and Scopus), for studies addressing ED, body image, muscle dysmorphia, weight and shape concern among Indigenous Australians, as well as diagnostic and screening tools. All relevant studies were reviewed in full by 2 researchers. Narrative synthesis of the data was performed. RESULTS There is limited evidence for ED among Indigenous Australians, however, the evidence available strongly suggests that ED are more common among Indigenous Australians compared to other Australians. Eating disorders among Indigenous Australians are also associated with high levels of overvaluation of weight and shape. The increased risk of ED among Indigenous Australians was largely explained by factors such as poorer psychosocial wellbeing. No evidence was found for the existence of validated diagnostic or screening tools for ED in Indigenous Australians. CONCLUSION The evidence suggests ED are common among Indigenous Australians, and there are no diagnostic or screening tools available to assist clinicians in assessing them. More research is required in this field, especially towards the development of a validated and culturally specific screening or diagnostic tool for ED among Indigenous Australians.
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Affiliation(s)
- Adam Burt
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia.
- Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, New South Wales, Australia.
| | - Kerrie Doyle
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia
- Campbelltown Hospital, SWSLHD, Campbelltown, Australia
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10
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Barriers and facilitators of sport and physical activity for Aboriginal and Torres Strait Islander children and adolescents: a mixed studies systematic review. BMC Public Health 2020; 20:601. [PMID: 32357870 PMCID: PMC7195755 DOI: 10.1186/s12889-020-8355-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 02/13/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Participation in sport and physical activity could minimise the inflated risk of poor physical health outcomes for Aboriginal and Torres Strait Islander children and adolescents. This review aimed to synthesise existing quantitative and qualitative literature regarding barriers and facilitators to physical activity and sports participation in Aboriginal and Torres Strait Islander children. METHODS Literature was systematically searched to include studies reporting barriers or facilitators to physical activity and/or sports participation in Aboriginal and Torres Strait Islander children aged 0-18 years. Using a pre-established taxonomy based on the social-ecological model, a deductive analysis was performed. Quality appraisal was performed using the Mixed Methods Appraisal Tool. RESULTS Of 3440 unique articles, nine studies were included with n = 10,061 total participants. Of the nine included studies one reported on participants from urban areas, two from regional and three from remote areas. Three were from representative samples of the Aboriginal and Torres Strait Islander population. Barriers were reported in all nine studies: 18 individual, 9 interpersonal, 27 community and 4 at the policy level (58 total); Facilitators were reported in five studies: 12 individual, 11 interpersonal, 11 community and 3 policy level (37 total). CONCLUSIONS Research in this area is lacking with some states in Australia not represented and small samples. Strategies for improving participation in sport and physical activity by Aboriginal and Torres Strait Islander children and adolescents need to integrate a comprehensive identification of barriers and facilitators with a social-ecological understanding of how community and cultural factors can impact individual participation.
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Bhat SK, Marriott R, Galbally M, Shepherd C. Psychosocial disadvantage and residential remoteness is associated with Aboriginal women's mental health prior to childbirth. Int J Popul Data Sci 2020; 5:1153. [PMID: 32935056 PMCID: PMC7473279 DOI: 10.23889/ijpds.v5i1.1153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Introduction Optimal mental health in the pre-conception, pregnancy and postpartum periods is important for both maternal and infant wellbeing. Few studies, however, have focused on Indigenous women and the specific risk and protective factors that may prompt vulnerability to perinatal mental disorders in this culturally diverse population. Objectives To assess mental health contacts in the period before childbirth among Australian Aboriginal and Torres Strait Islander women, the association with socioeconomic factors and whether it differs by geographic remoteness. Methods This is a retrospective cohort study of 19,165 Aboriginal mothers and includes all Aboriginal mothers and their children born in Western Australia from January 1990 to March 2015. It draws on population-level, linked administrative data from hospitals and mental health services, with a primary focus on the mental health contacts of Aboriginal women in the 5 years leading up to childbirth. Results The prevalence of maternal mental health contacts in the five years prior to birth was 27.6% (93.6% having a single mental health disorder), with a greater likelihood of contact in metropolitan areas compared with regional and remote settings. There was a positive relationship between socioeconomic advantage and the likelihood of a mental health contact for women in Metropolitan (β = 0.044, p=0.003) and Inner regional areas (β = 0.033, p=0.018), and a negative association in Outer regional (β = -0.038, p=0.022), Remote (β = -0.019, p=0.241) and Very remote regions (β = -0.053, p<0.001). Conclusions The findings from this study provide new insights on the dynamic relationship between SES, geographic location and mental health issues among Aboriginal women in the 5 years leading up to childbirth. The results underscore the need to apply location-specific approaches to addressing the material and psychosocial pathways that lead to mental health problems and the provision of culturally safe, appropriate and accessible services for Aboriginal women
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Affiliation(s)
- S K Bhat
- Ngangk Yira: Murdoch University Research Centre for Aboriginal Health and Social Equity, Australia
| | - R Marriott
- Ngangk Yira: Murdoch University Research Centre for Aboriginal Health and Social Equity, Australia
| | - M Galbally
- School of Psychology and Exercise Science, Murdoch University, Australia.,School of Medicine, University of Notre Dame, Australia.,King Edward Memorial Hospital, Australia
| | - Ccj Shepherd
- Ngangk Yira: Murdoch University Research Centre for Aboriginal Health and Social Equity, Australia.,Telethon Kids Institute, The University of Western Australia, Nedlands, Australia
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12
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Lima F, Shepherd C, Wong J, O’Donnell M, Marriott R. Trends in mental health related contacts among mothers of Aboriginal children in Western Australia (1990-2013): a linked data population-based cohort study of over 40 000 children. BMJ Open 2019; 9:e027733. [PMID: 31266837 PMCID: PMC6615791 DOI: 10.1136/bmjopen-2018-027733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE This study examines the scale of maternal mental health related contacts among Australian Aboriginal children over time, and associations with socio-economic characteristics, geographical remoteness and maternal age. DESIGN A retrospective cohort study of the prevalence of maternal mental health related contacts among Aboriginal children born in Western Australia between 1990 and 2013. SETTING Population of Western Australia with de-identified linked administrative data from the Western Australian Department of Health. PARTICIPANTS All Aboriginal children born in Western Australia between 1990 and 2013 and their mothers. PRIMARY OUTCOME MEASURE Prevalence of maternal mental health related contacts among Aboriginal children born between 1990 and 2013. Mental health related contacts were identified using mental health related inpatient hospitalisations and outpatient contacts. RESULTS Almost 30% of cohort children were born to a mother with at least one mental health contact in the 5 years prior to birth, with 15% reported in the year prior to birth and the year post birth. There was a distinct increase in the prevalence of maternal mental health contacts between 1990 and 2013 (4-5% per year, with a peak in 2007). Maternal mental health contacts were associated with living in more disadvantaged areas and major cities, and having a mother aged over 20 years at birth. CONCLUSIONS The study affirms that mental health issues place a considerable burden on Aboriginal Australia, and suggests that many of the mental health issues that women develop earlier in life are chronic at the time of conception, during pregnancy and at birth. Early intervention and support for women in the earliest stages of family planning are required to alleviate the burden of mental health problems at birth and after birth. There is a clear need for policies on the development of a holistic healthcare model, with a multisector approach, offering culturally appropriate services for Aboriginal people.
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Affiliation(s)
- Fernando Lima
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Carrington Shepherd
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- University of Western Australia, Nedlands, Western Australia, Australia
- Ngangk Yira Research Centre for Aboriginal Health & Social Equity, Murdoch University, Perth, Western Australia, Australia
| | - Janice Wong
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Centre & Discipline of Child and Adolescent Psychiatry, Psychosomatics & Psychotherapy, University of Western Australia, Nedlands, Western Australia, Australia
| | - Melissa O’Donnell
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- University of Western Australia, Nedlands, Western Australia, Australia
- Ngangk Yira Research Centre for Aboriginal Health & Social Equity, Murdoch University, Perth, Western Australia, Australia
| | - Rhonda Marriott
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Ngangk Yira Research Centre for Aboriginal Health & Social Equity, Murdoch University, Perth, Western Australia, Australia
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Segal L, Guy S, Leach M, Groves A, Turnbull C, Furber G. A needs-based workforce model to deliver tertiary-level community mental health care for distressed infants, children, and adolescents in South Australia: a mixed-methods study. LANCET PUBLIC HEALTH 2019; 3:e296-e303. [PMID: 29884435 DOI: 10.1016/s2468-2667(18)30075-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/06/2018] [Accepted: 04/06/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND High-quality mental health services for infants, children, adolescents, and their families can improve outcomes for children exposed to early trauma. We sought to estimate the workforce needed to deliver tertiary-level community mental health care to all infants, children, adolescents, and their families in need using a generalisable model, applied to South Australia (SA). METHODS Workforce estimates were determined using a workforce planning model. Clinical need was established using data from the Longitudinal Study of Australian Children and the Young Minds Matter survey. Care requirements were derived by workshopping clinical pathways with multiprofessional panels, testing derived estimates through an online survey of clinicians. FINDINGS Prevalence of tertiary-level need, defined by severity and exposure to childhood adversities, was estimated at 5-8% across infancy and childhood, and 16% in mid-adolescence. The derived care pathway entailed reception, triage, and follow-up (mean 3 h per patient), core clinical management (mean 27 h per patient per year), psychiatric oversight (mean 4 h per patient per year), specialised clinical role (mean 12 h per patient per year), and socioeconomic support (mean 12 h per patient per year). The modelled clinical full-time equivalent was 947 people and budget was AU$126 million, more than five times the current service level. INTERPRETATION Our novel needs-based workforce model produced actionable estimates of the community workforce needed to address tertiary-level mental health needs in infants, children, adolescents, and their families in SA. A considerable expansion in the skilled workforce is needed to support young people facing current distress and associated family-based adversities. Because mental illness is implicated in so many burgeoning social ills, addressing this shortfall could have wide-ranging benefits. FUNDING National Health and Medical Research Council (Australia), Department of Health SA.
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Affiliation(s)
- Leonie Segal
- Health Economics and Social Policy Group, University of South Australia, Adelaide, SA, Australia.
| | | | - Matthew Leach
- Department of Rural Health, University of South Australia, Adelaide, SA, Australia
| | - Aaron Groves
- Office of the Chief Psychiatrist, Tasmanian Department of Health and Human Services, Hobart, TAS, Australia
| | | | - Gareth Furber
- Health Counselling and Disability Services, Flinders University, Adelaide, SA, Australia
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Zarnowiecki D, Nguyen H, Catherine Hampton, Boffa J, Segal L. The Australian Nurse-Family Partnership Program for aboriginal mothers and babies: Describing client complexity and implications for program delivery. Midwifery 2018; 65:72-81. [DOI: 10.1016/j.midw.2018.06.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/13/2018] [Accepted: 06/17/2018] [Indexed: 10/28/2022]
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Feasibility of Implementing Infant Home Visiting in a Central Australian Aboriginal Community. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2018; 19:966-976. [PMID: 30054778 PMCID: PMC6182376 DOI: 10.1007/s11121-018-0930-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The Australian Nurse-Family-Partnership Program, an adaption of the Olds’ Nurse-Family-Partnership (NFP), commenced in Alice Springs in 2009 (Central Australia FPP), aiming to improve the health and social outcomes of Aboriginal mothers and infants. This study explores the feasibility of NFP implementation in a remote Australian Aboriginal community. Feasibility was defined by programme uptake by eligible women, retention in the programme, actual vs. scheduled visits and extent of programme content delivery. Programme uptake was established from pregnancy data in the patient Clinical Information System and programme referrals to December 31, 2015. Rates of withdrawal, retention and content delivery were derived from FPP data and compared with published NFP data. Modified Poisson regression was used to identify client characteristics associated with retention beyond the child’s first birthday. There were 469 valid referrals (43% of eligible pregnancies) and 299 women with at least one completed home visit by December 31, 2015. Of these, 41% completed the programme to the child’s second birthday and 53% beyond the child’s first birthday. Dominant reasons for leaving were “moved out of service area” (35%) and “declined further participation” (35%). There was a statistically significant positive association for programme retention with later gestational age at referral (RR = 1.27, p value = 0.03). A high proportion (75%) of scheduled visits was achieved and high delivery of programme content (80%). Central Australia FPP is the first implementation of the NFP model in a remote Aboriginal community. This study found that it can be implemented successfully in this setting. Outcome evaluation is needed to test achievement of hypothesised benefits.
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Intergenerational and early life influences on the well-being of Australian Aboriginal and Torres Strait Islander children: overview and selected findings from Footprints in Time, the Longitudinal Study of Indigenous Children. J Dev Orig Health Dis 2018; 10:17-23. [PMID: 29717680 DOI: 10.1017/s204017441800017x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Footprints in Time: The Longitudinal Study of Indigenous Children (LSIC) is a national study of 1759 Australian Aboriginal and Torres Strait Islander children living across urban, regional and remote areas of Australia. The study is in its 11th wave of annual data collection, having collected extensive data on topics including birth and early life influences, parental health and well-being, identity, cultural engagement, language use, housing, racism, school engagement and academic achievement, and social and emotional well-being. The current paper reviews a selection of major findings from Footprints in Time relating to the developmental origins of health and disease for Australian Aboriginal and Torres Strait Islander peoples. Opportunities for new researchers to conduct further research utilizing the LSIC data set are also presented.
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Segal L, Guy S, Furber G. What is the current level of mental health service delivery and expenditure on infants, children, adolescents, and young people in Australia? Aust N Z J Psychiatry 2018; 52:163-172. [PMID: 28709383 DOI: 10.1177/0004867417717796] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The study aim was to estimate the current level of ambulatory mental health service delivery to young people aged 0-24 years in Australia and associated government expenditure. Recognising the importance of the early years for the development of mental illness and socioeconomic outcomes, we were particularly interested in service access by infants and young children. METHODS We extracted information from government administrative datasets on the number of people who received mental health services, number of services and expenditure through the health sector for 2014-2015. Results are primarily reported by age groups 0-4, 5-11, 12-17 and 18-24 years. RESULTS Less than 1% of 0- to 4-year-olds received a mental health service in any one service setting, whereas nearly 11% of 18- to 24-year-olds received a mental health service through the Medicare Benefits Schedule Better Access programme alone. Many more services were delivered to 12- to 24-year-olds (>4 million) than to 0- to 11-year-olds (552,000). Medicare Benefits Schedule Better Access delivers services to more children and youth than do state/territory community mental health services, although the latter provide more services per client. In 2013-2014, Australian Government expenditure on ambulatory mental health services for 0- to 24-year-olds was AUD428 million, similar to the AUD491 million spent by state/territory governments. CONCLUSION The study provides a benchmark for data-driven service planning to ensure that the mental health needs of infants, children and young people are met. Our results indicate that the youngest age group are underserviced relative to need, even noting infants and children may receive services for behavioural/mental health issues from providers not captured in our study (such as paediatricians). The developmental origins of mental illness underlies the urgency of adequate provision by governments of perinatal, infant and child mental health services to avoid loss of life potential and reduce the pressures on the justice, child protection and welfare systems.
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Affiliation(s)
- Leonie Segal
- Health Economics and Social Policy Group, Centre for Population Health Research, University of South Australia, Adelaide, SA, Australia
| | - Sophie Guy
- Health Economics and Social Policy Group, Centre for Population Health Research, University of South Australia, Adelaide, SA, Australia
| | - Gareth Furber
- Health Economics and Social Policy Group, Centre for Population Health Research, University of South Australia, Adelaide, SA, Australia
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