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Esgin T, Macniven R, Crouch A, Martiniuk A. At the cultural interface: A systematic review of study characteristics and cultural integrity from twenty years of randomised controlled trials with Indigenous participants. DIALOGUES IN HEALTH 2023; 2:100097. [PMID: 38515470 PMCID: PMC10953858 DOI: 10.1016/j.dialog.2023.100097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/07/2022] [Accepted: 01/05/2023] [Indexed: 03/23/2024]
Abstract
Purpose and aim To identify and describe characteristics of Randomised Control Trial (RCT) design, implementation, and interpretation with a view tostrengtheningen the cultural integrity and scientific quality of this genre of research when used with, for and by Indigenous peoples. Issue RCTs are widely regarded as the 'gold standard' method for evaluating the efficacy of an intervention. However, issues of cultural acceptability and higher attrition rates among RCT participants from diverse populations, including Indigenous participants, have been reported. A better understanding of cultural acceptability and attrition rates of RCTs has the potential to impact the translation of findings into effective policies, programs and practice. Method A search of four electronic databases identified papers describing RCTs enrolling exclusively Australian Indigenous peoples over a 20-year period. The RCTs were assessed using: The Effective Public Health Practice Project's Quality Assessment Tool (EPHPP) and the Aboriginal & Torres Strait Islander Quality Appraisal Tool (QAT). The scores for each paper and the average scores of all papers were visualised using a Microsoft Excel™ Filled Radar Plot. Results Seventeen trials met the inclusion criteria. There was wide variation in the quality of the included trials as assessed by the EPHPP and almost universally poor results when assessed for cultural appropriateness and integrity by the QAT. Conclusion The value of the RCT research method, when applied to ultimately improve Australian Indigenous peoples' health, is diminished if issues of cultural integrity are not intrinsic to study design and execution. Our review found that it is feasible to have an RCT with both strong cultural integrity and high scientific quality. Attention to cultural integrity and community engagement, along with methodological rigour, may strengthen community ownership and contribute to more successful study adherence and potentially more effective translation of study findings into policy and practice.
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Affiliation(s)
- Tuguy Esgin
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, Discipline of Strategy, Innovation and Entrepreneurship, Business School, The University of Sydney, Sydney, New South Wales 2006, Australia
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia
- School of Management and Governance UNSW Business School, University of New South Wales Sydney, Kensington, New South Wales 2052, Australia
| | - Rona Macniven
- School of Population Health, Faculty of Medicine and Health, University of New South Wales Sydney, Kensington, New South Wales 2052, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales 2019, Australia
| | - Alan Crouch
- Department of Rural Health, The University of Melbourne, Ballarat Campus, Ballarat, Victoria 3350, Australia
| | - Alexandra Martiniuk
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales 2006, Australia
- Centre for Global Health Epidemiology Division, University of Toronto, Toronto, Ontario M5S 1A1, Canada
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2
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Hirchak KA, Oluwoye O, Nadeau M, Richardson M, Bajet K, Brigman M, Herron JL, Hernandez-Vallant A, Vasquez A, Pham C, Oliver KA, Baukol P, Webb K, Belone L, McDonell MG, Venner KL, Campbell ANC. Coming together for something good: recommendations from a scoping review for dissemination and implementation science to improve indigenous substance use disorder treatment. Front Public Health 2023; 11:1265122. [PMID: 37915816 PMCID: PMC10616787 DOI: 10.3389/fpubh.2023.1265122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction Dissemination and Implementation (D&I) science is growing among Indigenous communities. Indigenous communities are adapting and implementing evidence-based treatments for substance use disorders (SUD) to fit the needs of their communities. D&I science offers frameworks, models, and theories to increase implementation success, but research is needed to center Indigenous knowledge, enhancing D&I so that it is more applicable within Indigenous contexts. In this scoping review, we examined the current state of D&I science for SUD interventions among Indigenous communities and identified best-practice SUD implementation approaches. Methods PubMed and PsycINFO databases were queried for articles written in English, published in the United States, Canada, Australia, and New Zealand. We included key search terms for Indigenous populations and 35 content keywords. We categorized the data using the adapted and extended Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework that emphasizes equity and sustainability. RE-AIM has also been used as a primary model to consistently identify implementation outcomes. Results Twenty articles were identified from the original unduplicated count of over 24,000. Over half the articles discussed processes related to Reach, Adoption, and Implementation. Effectiveness was discussed by 50% of the studies (n = 10), with 25% of the articles discussing Maintenance/sustainability (n = 4). Findings also highlighted the importance of the application of each RE-AIM domain for meaningful, well-defined community-engaged approaches. Conclusion Finding indicated a need to prioritize Indigenous methods to culturally center, re-align and adapt Western treatments and frameworks to increase health equity and improve SUD treatment outcomes. Utility in the use of the modified RE-AIM and the continued modification for Indigenous communities was also noted.
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Affiliation(s)
- Katherine A. Hirchak
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Oladunni Oluwoye
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Melanie Nadeau
- Department of Indigenous Health, University of North Dakota, Grand Forks, ND, United States
| | - Meenakshi Richardson
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
- Department of Human Development, Washington State University, Vancouver, WA, United States
| | - Kelsey Bajet
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Mariah Brigman
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Jalene L. Herron
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM, United States
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Alexandra Hernandez-Vallant
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM, United States
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Angel Vasquez
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM, United States
| | - Cuong Pham
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States
| | | | - Paulette Baukol
- NorthStar Node, Hennepin Healthcare Research Institute, Minneapolis, MN, United States
| | - Kellie Webb
- Eastern Shoshone Recovery Center, Fort Washakie, WY, United States
| | - Lorenda Belone
- Population Health, University of New Mexico, Albuquerque, NM, United States
| | - Michael G. McDonell
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Kamilla L. Venner
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM, United States
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Aimee N. C. Campbell
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, NY, United States
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3
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McGee M, Shephard L, Sugito S, Baker D, Brienesse S, Al-Omary M, Nathan-Marsh R, Ngo DTM, Oakley P, Boyle AJ, Garvey G, Sverdlov AL. Mind The Gap, Aboriginal and Torres Strait Islander Cardiovascular Health: A Narrative Review. Heart Lung Circ 2023; 32:136-142. [PMID: 36336616 DOI: 10.1016/j.hlc.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 09/20/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022]
Abstract
Australia's First Nations Peoples, Aboriginal and Torres Strait Islanders, have reduced life expectancy compared to the wider community. Cardiovascular diseases, mainly driven by ischaemic heart disease, are the leading contributors to this disparity. Despite over a third of First Nations Peoples living in New South Wales, the bulk of the peer-reviewed literature is from Central Australia and Far North Queensland. Regardless of the site of publication, First Nations Peoples are significantly younger at disease onset and have higher rates of comorbidities, in turn driving adverse health events. On top of this, very few First Nations Peoples specific cardiovascular interventions or programs have been shown to improve outcomes. The traditional biomedical model of care is less efficacious and non-traditional models of communication such as clinical yarning may benefit both clinicians and patients. The key purpose of this review is to highlight the deficiencies of our knowledge of cardiovascular burden of disease for First Nations Peoples; and to serve as a catalyst for more dedicated research. We need to have relationships with communities and concentrate on community improvement and partnerships. By involving First Nations Peoples researchers in collaboration with local communities in all levels of health care design and intervention will improve outcomes.
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Affiliation(s)
- Michael McGee
- College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia; Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia
| | - Lauren Shephard
- College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia; Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia
| | - Stuart Sugito
- College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia; Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - David Baker
- College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Stephen Brienesse
- College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia; Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Mohammed Al-Omary
- College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia; Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Rhian Nathan-Marsh
- Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia
| | - Doan T M Ngo
- College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia. https://twitter.com/DoanNgo4
| | - Patrick Oakley
- College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia; Aboriginal Health Unit, Hunter New England Health, Wallsend Health Campus, Newcastle, NSW, Australia; General Medicine Department, John Hunter Hospital, Newcastle, NSW, Australia
| | - Andrew J Boyle
- College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia; Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia
| | - Aaron L Sverdlov
- College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia; Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia.
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4
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Luke J, Verbunt E, Zhang A, Bamblett M, Johnson G, Salamone C, Thomas D, Eades S, Gubhaju L, Kelaher M, Jones A. Questioning the ethics of evidence-based practice for Indigenous health and social settings in Australia. BMJ Glob Health 2022; 7:bmjgh-2022-009167. [PMID: 35680132 PMCID: PMC9185488 DOI: 10.1136/bmjgh-2022-009167] [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: 03/25/2022] [Accepted: 05/21/2022] [Indexed: 11/18/2022] Open
Abstract
Australian government planning promotes evidence-based action as the overarching goal to achieving health equality for Aboriginal and Torres Strait Islander populations. However, an inequitable distribution of power and resources in the conduct of evidence-based practice produces a policy environment counterintuitive to this goal. This context of contemporary evidence-based practice gives legitimacy to ‘expert practitioners’ located in Australian governments and universities to use Western guidelines and tools, embedded in Western methodology, to make ‘evidence’ informed policy and programming decisions about Aboriginal and Torres Strait Islander populations. This method for decision making assumes a positional superiority that can marginalise the important perspectives, experiences and knowledge of Aboriginal Community Controlled Organisations and their processes for decision making. Here we consider the four steps of an evidence review: (1) developing a review question; (2) acquiring studies; (3) appraising the evidence and (4) assessing the evidence, as components of wider evidence-based practice. We discuss some of the limitations across each step that arise from the broader context within which the evidence review is produced. We propose that an ethical and just approach to evidence-based review can be achieved through a well-resourced Aboriginal community controlled sector, where Aboriginal organisations generate their own evidence and evidence is reviewed using methods and tools that privilege Aboriginal and Torres Strait Islander ways of knowing, doing and being.
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Affiliation(s)
- Joanne Luke
- Centre for Health Policy, The University of Melbourne School of Population and Global Health, Carlton South, Victoria, Australia
| | - Ebony Verbunt
- Centre for Health Policy, The University of Melbourne School of Population and Global Health, Carlton South, Victoria, Australia
| | - Angela Zhang
- Centre for Health Policy, The University of Melbourne School of Population and Global Health, Carlton South, Victoria, Australia
| | - Muriel Bamblett
- Victorian Aboriginal Child Care Agency, Preston, Victoria, Australia
| | - Gabrielle Johnson
- Victorian Aboriginal Child Care Agency, Preston, Victoria, Australia
| | - Connie Salamone
- Victorian Aboriginal Child Care Agency, Preston, Victoria, Australia
| | - David Thomas
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Sandra Eades
- Centre for Epidemiology and Biostatistics, The School of Population and Global Health, The University of Melbourne, Carlton South, Victoria, Australia.,Curtin Medical School, Curtin University, Perth, Western Australia, Australia
| | - Lina Gubhaju
- Centre for Epidemiology and Biostatistics, The School of Population and Global Health, The University of Melbourne, Carlton South, Victoria, Australia
| | - Margaret Kelaher
- Centre for Health Policy, The University of Melbourne School of Population and Global Health, Carlton South, Victoria, Australia
| | - Amanda Jones
- Victorian Aboriginal Child Care Agency, Preston, Victoria, Australia
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Beer K, Gentgall M, Templeton N, Whitehouse C, Straiton N. Who's included? The role of the Clinical Research Nurse in enabling research participation for under-represented and under-served groups. J Res Nurs 2022; 27:143-154. [PMID: 35392191 PMCID: PMC8980581 DOI: 10.1177/17449871221077076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background There is a global call for more inclusive clinical research that is representative of all populations, particularly those historically under-represented or under-served. A lack of broad representation results in disproportionate health outcomes and limits the applicability and translation of research findings. Aim Identify and describe barriers to participation across the research lifecycle and consider the role of the Clinical Research Nurse (CRN) in promoting inclusivity, including for Aboriginal and Torres Strait Islander Peoples within Australia. Discussion Review of recent literature and best practice identified barriers to research participation across the research process; at system, participant and practitioner levels. This discussion paper explores the role of the CRN; acting as enablers, facilitators and navigators, to mitigate participation barriers. Conclusion With their comprehensive understanding of the research process, clinical care pathways, reflective practices and participant-centred approaches, CRNs are uniquely positioned to advocate for greater equity in access to clinical research and to motivate stakeholders across the research enterprise to embed inclusive approaches in the design, conduct and dissemination of research. Implications for Practice An in-depth understanding of the research process, self, and cultural norms of the populations they serve is essential for CRNs to effectively advocate for equity in access to research.
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Affiliation(s)
- Kelly Beer
- Kelly Beer, Perron Institute for Neurological and Translational Science; Murdoch University, Building 390, Discovery Way, Murdoch, WA 6150, Australia.
| | - Melanie Gentgall
- Clinical Research Nurse, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | | | - Claire Whitehouse
- Senior Nurse for Nursing, Midwifery and Allied Health Professions Research, The James Paget University Hospitals NHS Foundation Trust, Norfolk, UK
| | - Nicola Straiton
- Registered Nurse, Faculty of Medicine and Health, University of Sydney, NSW, Australia
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6
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Canuto KJ, Aromataris E, Burgess T, Davy C, McKivett A, Schwartzkopff K, Canuto K, Tufanaru C, Lockwood C, Brown A. A scoping review of Aboriginal and Torres Strait Islander health promotion programs focused on modifying chronic disease risk factors. Health Promot J Austr 2019; 32:46-74. [PMID: 31724783 PMCID: PMC7891321 DOI: 10.1002/hpja.307] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 10/31/2019] [Accepted: 11/06/2019] [Indexed: 11/09/2022] Open
Abstract
Issue addressed Noncommunicable chronic disease underlies much of the life expectancy gap experienced by Aboriginal and Torres Strait Islander people. Modifying contributing risk factors; tobacco smoking, nutrition, alcohol consumption, physical activity, social and emotional wellbeing (SNAPS) could help close this disease gap. This scoping review identified and describes SNAPS health promotion programs implemented for Aboriginal and Torres Strait Islander people in Australia. Methods Databases PubMed, CINAHL, Informit (Health Collection and Indigenous Peoples Collection), Scopus, Trove and relevant websites and clearing houses were searched for eligible studies until June 2015. To meet the inclusion criteria the program had to focus on modifying one of the SNAPS risk factors and the majority of participants had to identify as being of Aboriginal and/or Torres Strait Islander heritage. Results The review identified 71 health promotion programs, described in 83 publications. Programs were implemented across a range of health and community settings and included all Australian states and territories, from major cities to remote communities. The SNAPS factor addressed most commonly was nutrition. Some programs included the whole community, or had multiple key audiences, whilst others focused solely on one subgroup of the population such as chronic disease patients, pregnant women or youth. Fourteen of the programs reported no outcome assessments. Conclusions Health promotion programs for Aboriginal and Torres Strait Islander people have not been adequately evaluated. The majority of programs focused on the development of individual skills and changing personal behaviours without addressing the other health promotion action areas, such as creating supportive environments or reorienting health care services. So What? This scoping review provides a summary of the health promotion programs that have been delivered in Australia for Aboriginal and Torres Strait Islander people to prevent or manage chronic disease. These programs, although many are limited in quality, should be used to inform future programs. To improve evidence‐based health promotion practice, health promotion initiatives need to be evaluated and the findings published publicly.
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Affiliation(s)
- Karla J Canuto
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Edoardo Aromataris
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Teresa Burgess
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Carol Davy
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Andrea McKivett
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Kate Schwartzkopff
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Kootsy Canuto
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, Australia
| | - Catalin Tufanaru
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Craig Lockwood
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
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7
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Carlin E, Blondell SJ, Cadet-James Y, Campbell S, Williams M, Engelke C, Taverner D, Marriott R, Edmonds K, Atkinson D, Marley JV. Study protocol: a clinical trial for improving mental health screening for Aboriginal and Torres Strait Islander pregnant women and mothers of young children using the Kimberley Mum's Mood Scale. BMC Public Health 2019; 19:1521. [PMID: 31727039 PMCID: PMC6857148 DOI: 10.1186/s12889-019-7845-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/24/2019] [Indexed: 12/13/2022] Open
Abstract
Background Improving the rates of, and instruments used in, screening for perinatal depression and anxiety among Aboriginal and Torres Strait Islander women are important public health priorities. The Kimberley Mum’s Mood Scale (KMMS) was developed and later validated as an effective and acceptable perinatal depression and anxiety screening tool for the Kimberley region under research conditions. Other regions have expressed interest in using the KMMS with perinatal Aboriginal and Torres Strait Islander women. It is, however, important to re-evaluate the KMMS in a larger Kimberley sample via a real world implementation study, and to test for applicability in other remote and regional environments before recommendations for wider use can be made. This paper outlines the protocol for evaluating the process of implementation and establishing the ‘real world’ validity and acceptability of the KMMS in the Kimberley, Pilbara and Far North Queensland in northern Australia. Methods The study will use a range of quantitative and qualitative methods across all sites. KMMS validation/revalidation internal consistency of Part 1 will be determined using Cronbach’s alpha. Equivalence for identifying risk of depression and anxiety compared to a standard reference assessment will be determined from receiver operating characteristic curves. Sensitivity and specificity will be determined based on these cut-points. Qualitative methods of phenomenology will be used to explore concepts of KMMS user acceptability (women and health professionals). Additional process evaluation methods will collate, assess and report on KMMS quality review data, consultations with health service administrators and management, field notes, and other documentation from the research team. This information will be reported on using the Dynamic Sustainability Framework. Discussion This project is contributing to the important public health priority of screening Aboriginal and Torres Strait Islander women for perinatal depression and anxiety with tools that are meaningful and responsive to cultural and clinical needs. Identifying and addressing barriers to implementation contributes to our understanding of the complexity of improving routine clinical practie. Trial registration The study was registered retrospectively on 15/05/2019 with the Australian and New Zealand Clinical Trial registry (ACTRN12619000580178).
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Affiliation(s)
- Emma Carlin
- The Rural Clinical School of Western Australia, The University of Western Australia, 12 Napier Tce, PO Box 1377, Broome, WA, 6725, Australia. .,Kimberley Aboriginal Medical Services, 12 Napier Tce, PO Box 1377, Broome, WA, 6725, Australia.
| | - Sarah J Blondell
- The Rural Clinical School of Western Australia, The University of Western Australia, 12 Napier Tce, PO Box 1377, Broome, WA, 6725, Australia
| | - Yvonne Cadet-James
- Apunipima Cape York Health Council, 186 McCoombe Street, PO Box 12045, Bungalow, QLD, 4870, Australia
| | - Sandra Campbell
- Centre for Indigenous Health Equity Research, Central Queensland University, Cnr of Shields and Lake Streets, Cairns, QLD, 4870, Australia
| | - Melissa Williams
- Western Australian Country Health Service - Kimberley Population Health Unit, 4/9 Napier Tce (WA 6725 Locked Bag 525), Broome, WA, 6725, Australia
| | - Catherine Engelke
- The Rural Clinical School of Western Australia, The University of Western Australia, 12 Napier Tce, PO Box 1377, Broome, WA, 6725, Australia
| | - Des Taverner
- The Rural Clinical School of Western Australia, The University of Western Australia, 12 Napier Tce, PO Box 1377, Broome, WA, 6725, Australia
| | - Rhonda Marriott
- Ngangk Yira: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch University, 90 South Street, Murdoch, WA, 6150, Australia
| | - Karen Edmonds
- King's College London, 1 Lambeth Palace Road, Waterloo, London, SE1 7EU, UK
| | - David Atkinson
- The Rural Clinical School of Western Australia, The University of Western Australia, 12 Napier Tce, PO Box 1377, Broome, WA, 6725, Australia
| | - Julia V Marley
- The Rural Clinical School of Western Australia, The University of Western Australia, 12 Napier Tce, PO Box 1377, Broome, WA, 6725, Australia.,Kimberley Aboriginal Medical Services, 12 Napier Tce, PO Box 1377, Broome, WA, 6725, Australia
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8
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Beks H, Binder MJ, Kourbelis C, Ewing G, Charles J, Paradies Y, Clark RA, Versace VL. Geographical analysis of evaluated chronic disease programs for Aboriginal and Torres Strait Islander people in the Australian primary health care setting: a systematic scoping review. BMC Public Health 2019; 19:1115. [PMID: 31412846 PMCID: PMC6694647 DOI: 10.1186/s12889-019-7463-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/08/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Targeted chronic disease programs are vital to improving health outcomes for Indigenous people globally. In Australia it is not known where evaluated chronic disease programs for Aboriginal and Torres Strait Islander people have been implemented. This scoping review geographically examines where evaluated chronic disease programs for Aboriginal people have been implemented in the Australian primary health care setting. Secondary objectives include scoping programs for evidence of partnerships with Aboriginal organisations, and use of ethical protocols. By doing so, geographical gaps in the literature and variations in ethical approaches to conducting program evaluations are highlighted. METHODS The objectives, inclusion criteria and methods for this scoping review were specified in advance and documented in a published protocol. This scoping review was undertaken in accordance with the Joanna Briggs Institute (JBI) scoping review methodology. The search included 11 academic databases, clinical trial registries, and the grey literature. RESULTS The search resulted in 6894 citations, with 241 retrieved from the grey literature and targeted organisation websites. Title, abstract, and full-text screening was conducted by two independent reviewers, with 314 citations undergoing full review. Of these, 74 citations evaluating 50 programs met the inclusion criteria. Of the programs included in the geographical analysis (n = 40), 32.1% were implemented in Major Cities and 29.6% in Very Remote areas of Australia. A smaller proportion of programs were delivered in Inner Regional (12.3%), Outer Regional (18.5%) and Remote areas (7.4%) of Australia. Overall, 90% (n = 45) of the included programs collaborated with an Aboriginal organisation in the implementation and/or evaluation of the program. Variation in the use of ethical guidelines and protocols in the evaluation process was evident. CONCLUSIONS A greater focus on the evaluation of chronic disease programs for Aboriginal people residing in Inner and Outer Regional areas, and Remote areas of Australia is required. Across all geographical areas further efforts should be made to conduct evaluations in partnership with Aboriginal communities residing in the geographical region of program implementation. The need for more scientifically and ethically rigorous approaches to Aboriginal health program evaluations is evident.
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Affiliation(s)
- Hannah Beks
- Deakin Rural Health, Deakin University, School of Medicine, Geelong, Victoria, Australia
| | - Marley J Binder
- Deakin Rural Health, Deakin University, School of Medicine, Geelong, Victoria, Australia
| | - Constance Kourbelis
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia, Australia
| | - Geraldine Ewing
- Deakin Rural Health, Deakin University, School of Medicine, Geelong, Victoria, Australia
| | - James Charles
- Institute of Koorie Education, Deakin University, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Yin Paradies
- Faculty of Arts and Education, Deakin University, Burwood, Victoria, Australia
| | - Robyn A Clark
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia, Australia
| | - Vincent L Versace
- Deakin Rural Health, Deakin University, School of Medicine, Geelong, Victoria, Australia.
- National Centre for Farmer Health, Western District Health Service, Hamilton, Victoria, Australia.
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9
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Santos MDDV, Santos SV, Caccia-Bava MDCGG. [The prevalence of strategies for cessation of tobacco use in primary health care: an integrative review]. CIENCIA & SAUDE COLETIVA 2019; 24:563-572. [PMID: 30726388 DOI: 10.1590/1413-81232018242.27712016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 03/23/2017] [Indexed: 11/22/2022] Open
Abstract
The habit of tobacco use/smoking, which is a major concern of Primary Health Care (PHC), is a serious public health problem and the main avoidable cause of death in the world. The relevance of actions, whose focus is to facilitate the cessation of this habit, motivates the discussion of studies that have different approaches to tackle this issue by seeking to train PHC professionals accordingly. A search was conducted in the Lilacs, MEDLINE and Web of Science databases for recent scientific publications (2010-2015). The key words were combined with Boolean operators and, after analysis of the articles found, 75 are discussed in this article since they have strategies with a higher prevalence in PHC. The conclusion drawn is that the brief or intense individual approach using the 5A method (Transtheoretical Model) is the most widely adopted, as well as bupropion and nicotine replacement patches. The increasing use of hard technology requires new studies that examine their impact on the treatment of smokers. It was clearly revealed that there is a need for health professionals to be better prepared to address the issue with the users, in addition to a lack of stimulus and proper conditions to work in the PHC team directly reflecting scientific advances in clinical practice.
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Affiliation(s)
- Meire de Deus Vieira Santos
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes 3900, Monte Alegre. 14048-900 Ribeirão Preto SP Brasil.
| | - Stella Vieira Santos
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes 3900, Monte Alegre. 14048-900 Ribeirão Preto SP Brasil.
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10
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Kirke AB, Atkinson D, Moore S, Sterry K, Singleton S, Roxburgh C, Parrish K, Porter C, Marley JV. Diabetes screening in pregnancy failing women in rural Western Australia: An audit of oral glucose tolerance test completion rates. Aust J Rural Health 2019; 27:64-69. [PMID: 30693987 DOI: 10.1111/ajr.12465] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To quantify screening rate for gestational diabetes mellitus and completion of oral glucose tolerance test in rural and remote Western Australia. DESIGN AND PARTICIPANTS Retrospective audit of 551 antenatal records from women of 16 years and older without pre-existing diabetes and with singleton pregnancies delivered in 2013. MAIN OUTCOME MEASURES Number of women recorded screened for gestational diabetes mellitus in second or third trimester using oral glucose tolerance test or other tests; gestational diabetes mellitus rate. RESULTS Only 278 (50.5%) women were screened with oral glucose tolerance test; 113 (20.5%) had no record of any screening related to gestational diabetes mellitus. In a nested mixed-effects logistic regression model, women with a previous gestational diabetes mellitus diagnosis, two or more risk factors (excluding ethnicity) or high-risk gestational diabetes mellitus ethnicity other than Australian Aboriginal were more likely to be screened, while Australian Aboriginal women were less likely to be screened with oral glucose tolerance test. Clinicians reported patient and clinician factors and logistical difficulties as reasons for the oral glucose tolerance test not being completed at their site. Of those screened with oral glucose tolerance test, a high rate of gestational diabetes mellitus was diagnosed (14.7% versus Western Australia state-wide average of 7.4%). CONCLUSION Adherence to oral glucose tolerance test screening in rural Western Australia is inadequate for effective screening for gestational diabetes mellitus. Screening was not acceptable or available for a significant proportion of women at risk. Efforts to improve oral glucose tolerance test adherence and exploration of alternative gestational diabetes mellitus screening strategies are required.
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Affiliation(s)
- Andrew B Kirke
- Rural Clinical School of Western Australia, University of Western Australia, Bunbury, Western Australia, Australia
| | - David Atkinson
- Rural Clinical School of Western Australia, University of Western Australia, Bunbury, Western Australia, Australia.,Kimberley Aboriginal Medical Services Council, Broome, Western Australia, Australia
| | - Sarah Moore
- Rural Clinical School of Western Australia, University of Western Australia, Bunbury, Western Australia, Australia
| | - Kylie Sterry
- Rural Clinical School of Western Australia, University of Western Australia, Bunbury, Western Australia, Australia
| | - Sally Singleton
- Rural Clinical School of Western Australia, University of Western Australia, Bunbury, Western Australia, Australia.,Kimberley Aboriginal Medical Services Council, Broome, Western Australia, Australia
| | - Carly Roxburgh
- Rural Clinical School of Western Australia, University of Western Australia, Bunbury, Western Australia, Australia
| | - Kate Parrish
- Veterinary Virology, Elizabeth Macarthur Agricultural Institute, Menangle, New South Wales, Australia
| | - Cindy Porter
- Combined Universities Centre for Rural Health, Geraldton, Western Australia, Australia
| | - Julia V Marley
- Rural Clinical School of Western Australia, University of Western Australia, Bunbury, Western Australia, Australia.,Kimberley Aboriginal Medical Services Council, Broome, Western Australia, Australia
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11
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Bar-Zeev Y, Bonevski B, Bovill M, Gruppetta M, Oldmeadow C, Palazzi K, Atkins L, Reath J, Gould GS. The Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy Pilot Study protocol: a feasibility step-wedge cluster randomised trial to improve health providers' management of smoking during pregnancy. BMJ Open 2017; 7:e016095. [PMID: 28780551 PMCID: PMC5629642 DOI: 10.1136/bmjopen-2017-016095] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Indigenous women have the highest smoking prevalence during pregnancy (47%) in Australia. Health professionals report lack of knowledge, skills and confidence to effectively manage smoking among pregnant women in general. We developed a behaviour change intervention aimed to improve health professionals' management of smoking in Indigenous pregnant women-the Indigenous Counselling And Nicotine (ICAN) QUIT in Pregnancy. This intervention includes webinar training for health professionals, an educational resources package for health professionals and pregnant women, free oral nicotine replacement therapy (NRT) for pregnant women, and audit and feedback on health professionals' performance.The aim of this study is to test the feasibility and acceptability of the ICAN QUIT in Pregnancy intervention to improve health professionals' provision of evidence-based culturally responsive smoking cessation care to Australian Indigenous pregnant smokers. METHODS AND ANALYSIS This protocol describes the design of a step-wedge cluster randomised pilot study. Six Aboriginal Medical Services (AMSs) are randomised into three clusters. Clusters receive the intervention staggered by 1 month. Health professionals report on their knowledge and skills pretraining and post-training and at the end of the study. Pregnant women are recruited and followed up for 3 months. The primary outcome is the recruitment rate of pregnant women. Secondary outcomes include feasibility of recruitment and follow-up of participating women, and webinar training of health professionals, measured using a designated log; and measures of effectiveness outcomes, including quit rates and NRT prescription rates. ETHICS AND DISSEMINATION In accordance with the Aboriginal Health and Medical Research Council guidelines, this study has been developed in collaboration with a Stakeholder and Consumer Aboriginal Advisory Panel (SCAAP). The SCAAP provides cultural consultation, advice and direction to ensure that implementation is acceptable and respectful to the Aboriginal communities involved. Results will be disseminated to AMSs, Aboriginal communities and national Aboriginal bodies. REGISTRATION DETAILS This protocol (version 4, 14 October 2016) is registered with the Australian and New Zealand Clinical Trials Registry (Ref #: ACTRN12616001603404).
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Affiliation(s)
- Yael Bar-Zeev
- The University of Newcastle, Newcastle, New South Wales, Australia
| | - Billie Bonevski
- The University of Newcastle, Newcastle, New South Wales, Australia
| | - Michelle Bovill
- The University of Newcastle, Newcastle, New South Wales, Australia
| | - Maree Gruppetta
- The University of Newcastle, Newcastle, New South Wales, Australia
| | - Chris Oldmeadow
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Kerrin Palazzi
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Lou Atkins
- Centre for Behaviour Change, University College London, London, UK
| | - Jennifer Reath
- Western Sydney University, Penrith, New South Wales, Australia
| | - Gillian S Gould
- The University of Newcastle, Newcastle, New South Wales, Australia
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12
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Graham VE, Campbell S, West C, Clough AR. Substance misuse intervention research in remote Indigenous Australian communities since the NHMRC ‘Roadmap’. Aust N Z J Public Health 2017; 41:424-431. [DOI: 10.1111/1753-6405.12691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/01/2017] [Accepted: 04/01/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Veronica E. Graham
- Australian Institute of Tropical Health and Medicine; James Cook University; Queensland
| | - Sandra Campbell
- Centre for Chronic Disease Prevention; James Cook University; Queensland
| | - Caryn West
- School of Nursing, Midwifery & Nutrition; James Cook University; Queensland
| | - Alan R. Clough
- Australian Institute of Tropical Health and Medicine; James Cook University; Queensland
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13
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Bovill M, Bar-Zeev Y, Gruppetta M, O'Mara P, Cowling B, Gould GS. Collective and negotiated design for a clinical trial addressing smoking cessation supports for Aboriginal and Torres Strait Islander mothers in NSW, SA and Qld – developing a pilot study. Aust J Prim Health 2017; 23:497-503. [DOI: 10.1071/py16140] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/16/2017] [Indexed: 11/23/2022]
Abstract
Tobacco smoking leads to one in five deaths of Aboriginal Australians and accounts for 17% of the reversible health gap. One in two Aboriginal women are reported to smoke during pregnancy, with no effective strategies currently available for health practitioners to utilise for supporting Aboriginal women. Aboriginal community participation in primary health research is crucial to implementing ethical research, with a clear benefit to the people and communities involved. However, currently there is little evidence on how Aboriginal programs and interventions are being developed in partnership with Aboriginal people and communities. ‘Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy’ aims to address the prevalence of smoking during pregnancy by enhancing health providers’ training in offering evidence-based smoking cessation care to Aboriginal mothers during pregnancy. This paper outlines the participatory research approach adopted for the developmental phase of the ‘ICAN QUIT in Pregnancy’ project developed in partnership with two Aboriginal Community-Controlled Health Services in NSW, and negotiation processes undertaken to implement a pilot intervention across NSW, SA and Qld.
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14
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Minichiello A, Lefkowitz ARF, Firestone M, Smylie JK, Schwartz R. Effective strategies to reduce commercial tobacco use in Indigenous communities globally: A systematic review. BMC Public Health 2016; 16:21. [PMID: 26754922 PMCID: PMC4710008 DOI: 10.1186/s12889-015-2645-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 12/18/2015] [Indexed: 11/30/2022] Open
Abstract
Background All over the world, Indigenous populations have remarkably high rates of commercial tobacco use compared to non-Indigenous groups. The high rates of commercial tobacco use in Indigenous populations have led to a variety of health issues and lower life expectancy than the general population. The objectives of this systematic review were to investigate changes in the initiation, consumption and quit rates of commercial tobacco use as well as changes in knowledge, prevalence, community interest, and smoke-free environments in Indigenous populations. We also aimed to understand which interventions had broad reach, what the common elements that supported positive change were and how Aboriginal self-determination was reflected in program implementation. Methods We undertook a systematic review of peer-reviewed publications and grey literature selected from seven databases and 43 electronic sources. We included studies between 1994 and 2015 if they addressed an intervention (including provision of a health service or program, education or training programs) aimed to reduce the use of commercial tobacco use in Indigenous communities globally. Systematic cross-regional canvassing of informants in Canada and internationally with knowledge of Indigenous health and/or tobacco control provided further leads about commercial tobacco reduction interventions. We extracted data on program characteristics, study design and learnings including successes and challenges. Results In the process of this review, we investigated 73 commercial tobacco control interventions in Indigenous communities globally. These interventions incorporated a myriad of activities to reduce, cease or protect Indigenous peoples from the harms of commercial tobacco use. Interventions were successful in producing positive changes in initiation, consumption and quit rates. Interventions also facilitated increases in the number of smoke-free environments, greater understandings of the harms of commercial tobacco use and a growing community interest in addressing the high rates of commercial tobacco use. Interventions were unable to produce any measured change in prevalence rates. Conclusions The extent of this research in Indigenous communities globally suggests a growing prioritization and readiness to address the high rates of commercial tobacco use through the use of both comprehensive and tailored interventions. A comprehensive approach that uses multiple activities, the centring of Aboriginal leadership, long term community investments, and the provision of culturally appropriate health materials and activities appear to have an important influence in producing desired change. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2645-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexa Minichiello
- Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Ayla R F Lefkowitz
- Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Michelle Firestone
- Well Living House Action Research Centre for Indigenous Infant, Child and Family Health and Wellbeing,, St. Michael's Hospital, Toronto, Canada. .,Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Janet K Smylie
- Well Living House Action Research Centre for Indigenous Infant, Child and Family Health and Wellbeing,, St. Michael's Hospital, Toronto, Canada. .,Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Robert Schwartz
- Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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15
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Glover M, Kira A, Smith C. Enlisting “Aunties” to Support Indigenous Pregnant Women to Stop Smoking: Feasibility Study Results. Nicotine Tob Res 2015; 18:1110-5. [DOI: 10.1093/ntr/ntv146] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 06/17/2015] [Indexed: 11/15/2022]
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16
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Davey ME, Hunt JM, Foster R, Couzos S, Sterren AE, Sarin J, Thomas DP. Tobacco control policies and activities in Aboriginal community‐controlled health services. Med J Aust 2015; 202:S63-6. [DOI: 10.5694/mja15.00200] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/06/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Maureen E Davey
- Aboriginal Health Service, Tasmanian Aboriginal Centre, Hobart, TAS
| | | | - Raylene Foster
- Aboriginal Health Service, Tasmanian Aboriginal Centre, Hobart, TAS
| | | | | | - Jasmine Sarin
- Aboriginal Health & Medical Research Council, Sydney, NSW
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17
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Mc Loughlin F, Hadgraft NT, Atkinson D, Marley JV. Aboriginal health research in the remote Kimberley: an exploration of perceptions, attitudes and concerns of stakeholders. BMC Health Serv Res 2014; 14:517. [PMID: 25343849 PMCID: PMC4213490 DOI: 10.1186/s12913-014-0517-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 10/13/2014] [Indexed: 11/10/2022] Open
Abstract
Background For decades Indigenous peoples have argued for health research reform claiming methods used and results obtained often reflect the exploitative history of colonisation. In 2006 the Kimberley Aboriginal Health Planning Forum (KAHPF) Research Subcommittee (hereafter, the Subcommittee) was formed to improve research processes in the remote Kimberley region of north Western Australia. This paper explores the major perceptions, attitudes and concerns of stakeholders in the Subcommittee. Methods Qualitative analysis was carried out on data retrospectively collected from multiple evidentiary sources linked to the Subcommittee i.e. database, documents, interviews, review forms and emails from 1 January 2007 to 31 October 2013. Results From 1 January 2007 to 30 June 2013 the Subcommittee received 95 proposals, 57 (60%) driven by researchers based outside the region. Local stakeholders (22 from 12 different Kimberley organisations) raised concerns about 36 (38%) projects, 30 (83%) of which were driven by external researchers. Major concerns of local stakeholders were inadequate community consultation and engagement; burden of research on the region; negative impact of research practices; lack of demonstrable community benefit; and power and control of research. Major themes identified by external stakeholders (25 external researchers who completed the review form) were unanticipated difficulties with consultation processes; barriers to travel; perceiving research as a competing priority for health services and time-consuming ethics processes. External stakeholders also identified strategies for improving research practices in the Kimberley: importance of community support in building good relationships; employing local people; flexibility in research approaches; and importance of allocating sufficient time for consultation and data collection. Conclusions Health research in the Kimberley has improved in recent years, however significant problems remain. Prioritising research addressing genuine local needs is essential in closing the gap in Indigenous life expectancy. The long-term aim is for local health service connected researchers to identify priorities, lead, conduct and participate in the majority of local health research. For this to occur, a more radical move involving reconceptualising the research process is needed. Changes to institutional timeframes and funding processes could improve Indigenous and community-based research.
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Affiliation(s)
- Frieda Mc Loughlin
- Kimberley Aboriginal Medical Services Council, 12 Napier Terrace, PO Box 1377, Broome, WA, 6725, Australia.
| | - Nyssa T Hadgraft
- Kimberley Aboriginal Medical Services Council, 12 Napier Terrace, PO Box 1377, Broome, WA, 6725, Australia.
| | - David Atkinson
- Kimberley Aboriginal Medical Services Council, 12 Napier Terrace, PO Box 1377, Broome, WA, 6725, Australia. .,The Rural Clinical School of Western Australia, The University of Western Australia, 12 Napier Terrace, PO Box 1377, Broome, WA, 6725, Australia.
| | - Julia V Marley
- Kimberley Aboriginal Medical Services Council, 12 Napier Terrace, PO Box 1377, Broome, WA, 6725, Australia. .,The Rural Clinical School of Western Australia, The University of Western Australia, 12 Napier Terrace, PO Box 1377, Broome, WA, 6725, Australia.
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