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Taylor N, Livingston M. The market matters: Shifting the minimum unit price. Drug Alcohol Rev 2024; 43:1331-1333. [PMID: 38741360 DOI: 10.1111/dar.13866] [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: 02/01/2024] [Revised: 04/05/2024] [Accepted: 04/30/2024] [Indexed: 05/16/2024]
Affiliation(s)
- Nicholas Taylor
- National Drug Research Institute, Curtin University, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
- School of Psychology, Deakin University, Geelong, Australia
| | - Michael Livingston
- National Drug Research Institute, Curtin University, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
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Clifford S, Crundall I. COVID-19 as a catalyst for alcohol policy change: A case study of the Gove Peninsula. Drug Alcohol Rev 2024; 43:1445-1450. [PMID: 38956933 DOI: 10.1111/dar.13895] [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: 12/06/2023] [Revised: 06/06/2024] [Accepted: 06/14/2024] [Indexed: 07/04/2024]
Abstract
In many ways, the COVID-19 pandemic provided a natural experiment for alternate ways of living and working. Although alcohol supply was one of many aspects impacted by COVID-19 restrictions, few of those alcohol-related measures have been continued. This commentary presents a unique case study from the Gove Peninsula in northern Australia, where pandemic restrictions acted as a catalyst for a review of an established alcohol management system. A permit system was introduced on the Gove Peninsula in 2008 to control who can purchase takeaway alcohol and how much they could buy each day. Development of the system was rooted in the principles of community development and self-determination. This commentary describes how COVID-19 and associated changes in levels of alcohol harms mobilised community support for a review of the system, that had operated unchanged for the past decade. COVID-19 was adventitious in revealing compelling localised information which encouraged examination of potential improvements to the system. An updated regime is now being trialled, which sets daily limits on the alcohol purchases of everyone in the area. This experience illustrates the benefits of timely and relevant data to assist communities in formulating local solutions to local problems.
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Affiliation(s)
- Sarah Clifford
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
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Baldwin R, Coomber K, Scott D, Paradies Y, Boffa J, Miller PG. Trends in child and adolescent assault and maltreatment following the re-introduction of the Banned Drinker Register in the Northern Territory, Australia. CHILD ABUSE & NEGLECT 2024; 154:106939. [PMID: 38991622 DOI: 10.1016/j.chiabu.2024.106939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 06/21/2024] [Accepted: 07/01/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE In 2017 the Northern Territory (NT) government re-introduced the Banned Drinker Register (BDR) to address the high rates of alcohol related harm. This paper aims to evaluate whether trends in assault, maltreatment and sentinel injuries in children and adolescents were associated with the re-introduction of the BDR, in the context of other local interventions such as police officers stationed in bottle shops being partially removed, Police Auxiliary Liquor Inspectors, and the introduction of a minimum unit price of alcohol. METHOD Interrupted time series analysis was used to assess monthly trends in emergency department presentations and inpatient hospital admissions for assault, maltreatment and sentinel injuries between January 2014 and December 2019 in the regions of Greater Darwin, Alice Springs, and Katherine. RESULTS A significant step increase after the introduction of the BDR in emergency department presentations for assault and maltreatment was present when examining the three regions combined (β = 7.65, 95 % CI = 2.15, 13.16). However, this was not present at the individual community level. Results across a range of other models pointed towards null effects of the BDR introduction. CONCLUSIONS The current study found that the re-introduction of the BDR had minimal impact on rates of assault, maltreatment, or sentinel injuries in children and adolescents. To ensure long-term harm mitigation from alcohol use, a combination of evidence informed alcohol policies that address the price and availability of alcohol in a comprehensive framework, along with measures which address the underlying social determinants of unregulated drinking and health more broadly will assist in reducing alcohol related harm in both children and adults.
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Affiliation(s)
- Ryan Baldwin
- School of Psychology, Deakin University, Geelong, Victoria, Australia.
| | - Kerri Coomber
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Debbie Scott
- Eastern Health Clinical School and Monash Addiction Research Centre, Monash University, Box Hill, Australia; Turning Point, Eastern Health, Richmond, Australia; Australia Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia; GLOBE, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Yin Paradies
- School of Human and Social Science, Deakin University, Burwood, Victoria, Australia
| | - John Boffa
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Peter G Miller
- School of Psychology, Deakin University, Geelong, Victoria, Australia
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Clifford S, Wright CJC, Miller PG, Coomber K, Griffiths KE, Smith JA, Livingston M. What are the impacts of alcohol supply reduction measures on police-recorded adult domestic and family violence in the Northern Territory of Australia? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 127:104426. [PMID: 38640706 DOI: 10.1016/j.drugpo.2024.104426] [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: 11/26/2023] [Revised: 03/13/2024] [Accepted: 04/10/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND During 2017-18, the Northern Territory (NT) introduced a Banned Drinker Register (BDR) and Minimum Unit Price (MUP) NT-wide; Police Auxiliary Liquor Inspectors (PALIs) in three regional towns; and restrictions on daily purchases/opening hours (DPOH) in one regional town. The BDR is an individual-level alcohol ban; MUP is a pricing policy; and PALIs enforce bans on restricted areas at takeaway outlets. This study examines the impact of these policies on adult domestic and family violence (DFV). METHODS We examined DFV assaults and breaches of violence orders from January 2014 - February 2020 using interrupted time series models for NT, Greater Darwin, Katherine, Tennant Creek, and Alice Springs. To account for increasing numbers of individuals on the BDR we tested two timepoints (Sept 2017, March 2018). FINDINGS Following DPOH, assaults (78 %) and alcohol-involved assaults (92 %) decreased in Tennant Creek. After PALIs, assaults (79 %) in Tennant Creek, and breaches (39 %) and alcohol-involved breaches (58 %) in Katherine decreased. After MUP, assaults (11 %), alcohol-involved assaults (21 %) and alcohol-involved breaches (21%) decreased NT wide. After MUP/PALIs in Alice Springs, alcohol-involved assaults (33 %), breaches (42 %), and alcohol-involved breaches (57 %) decreased. BDR (Sept 2017) found increases in assaults (44 %) and alcohol-involved assaults (39 %) in Katherine and assaults (10%) and alcohol-involved assaults NT-wide (17 %). There were increases of 21 %-45 % in breaches NT-wide, in Darwin, Katherine, and Alice Springs. Following March 2018 found increases in assaults (33 %) and alcohol-involved assaults (48 %) in Katherine. There were increases - from 20 % to 56 % - in breaches in NT-wide, Katherine, and Alice Springs. CONCLUSION PALIs and DPOH were associated with some reductions in DFV; the BDR was associated with some increases. The upward trend commences prior to the BDR, so it is also plausible that the BDR had no effect on DFV outcomes. Although MUP was associated with reductions in the NT-wide model, there were no changes in sites without cooccurring PALIs.
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Affiliation(s)
- Sarah Clifford
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
| | - Cassandra J C Wright
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia; Burnet Institute, Melbourne, Australia; Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Peter G Miller
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia; School of Psychology, Deakin University, Geelong, Australia; National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Kerri Coomber
- School of Psychology, Deakin University, Geelong, Australia
| | - Kalinda E Griffiths
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia; Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia; Centre for Health Equity, University of Melbourne, Melbourne, Australia; College of Medicine and Public Health, Flinders University, Darwin, Australia
| | - James A Smith
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia; School of Psychology, Deakin University, Geelong, Australia; College of Medicine and Public Health, Flinders University, Darwin, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; National Drug Research Institute, Curtin University, Melbourne, Australia
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Baldwin R, Miller PG, Coomber K, Scott D, Paradies Y. Impacts of Northern Territory banned drinker register on police recorded youth assault. Drug Alcohol Rev 2024; 43:529-538. [PMID: 38231668 DOI: 10.1111/dar.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 01/19/2024]
Abstract
INTRODUCTION In September 2017 the Northern Territory Government of Australia introduced a banned drinker register (BDR) to mitigate the high levels of alcohol-related harm within the Northern Territory. The current study aimed to examine the impact of the Northern Territory BDR on youth (aged <18 years) using police recorded assault data. METHODS Interrupted time-series models were used to assess monthly trends in assaults and alcohol-related assaults perpetration and victimisation in the regions of Greater Darwin, Alice Springs and Katherine between January 2014 and December 2019. RESULTS Examining the three regions combined, after the re-introduction of the BDR a significant step decrease in police recorded youth assault perpetration (β = -1.67) and a significant step increase in police recorded youth assault victimisation (β = 1.40) was identified. However, no significant effects were identified at the individual region level. DISCUSSION AND CONCLUSIONS Findings suggest that restricting alcohol consumption in high-risk adults through the BDR had a limited immediate effect in police recorded youth assaults. Individual level or contextual factors may have influenced both immediate and long-term impacts of the BDR, and as such, future policy design needs to support and empower community leaders across the policy development and implementation process. A wider evaluation of the BDR currently underway may provide additional understanding behind the mechanisms that underpin alcohol-related harm in the Northern Territory.
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Affiliation(s)
- Ryan Baldwin
- School of Psychology, Deakin University, Geelong, Australia
| | - Peter G Miller
- School of Psychology, Deakin University, Geelong, Australia
| | - Kerri Coomber
- School of Psychology, Deakin University, Geelong, Australia
| | - Debbie Scott
- Australia Institute for Health Transformation, Deakin University, Geelong, Australia
- GLOBE, School of Health and Social Development, Deakin University, Geelong, Australia
| | - Yin Paradies
- School of Human and Social Science, Deakin University, Melbourne, Australia
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Clifford S, Wright CJC, Miller PG, Baldwin R, Griffiths KE, Smith JA, Livingston M. Police-recorded adult sexual assault in the Northern Territory, Australia: Alcohol involvement and alcohol policy effects. Drug Alcohol Rev 2024; 43:519-528. [PMID: 38055335 DOI: 10.1111/dar.13787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 10/23/2023] [Accepted: 11/04/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION Between 2017 and 2018 three major alcohol policy changes were introduced in the Northern Territory (NT): the Banned Drinker Register, an individual-level ban enforced via ID scanners at takeaway outlets; a Minimum Unit Price on alcohol; and Police Auxiliary Liquor Inspectors, who monitor takeaway outlets to prevent purchase by people who do not have a legal place to consume alcohol. We aimed to: (i) describe alcohol-involved adult sexual assault in the NT; and (ii) estimate the impacts of these alcohol policies on police-recorded adult sexual assault. METHODS We used victim records for sexual assault where victims were aged 15 years and over. We undertook descriptive analyses for the NT from 2014 to 2020 and used interrupted time series analysis to assess policy impacts across the NT and in Greater Darwin. RESULTS In 2020, the NT adult victimisation rate was 105 per 100,000. A large minority (40%) of adult sexual assaults involved alcohol. Interrupted time series analyses showed no effect of the Banned Drinker Register or Minimum Unit Price on sexual assault across the NT or in Greater Darwin. DISCUSSION AND CONCLUSIONS The rate of adult sexual assaults in the NT is extremely high and many involve alcohol. Neither the Banned Drinker Register or Minimum Unit Price were associated with changes in police-recorded adult sexual assault in Greater Darwin or across the NT. Due to small counts, we were unable to assess policy impacts in three of the four main towns, highlighting the challenges of assessing impacts of policies on sexual assault in small population areas.
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Affiliation(s)
- Sarah Clifford
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Cassandra J C Wright
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
| | - Peter G Miller
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- School of Psychology, Deakin University, Geelong, Australia
- National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Ryan Baldwin
- School of Psychology, Deakin University, Geelong, Australia
| | - Kalinda E Griffiths
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
- College of Medicine and Public Health, Flinders University, Darwin, Australia
- Centre for Health Equity, University of Melbourne, Australia
| | - James A Smith
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- School of Psychology, Deakin University, Geelong, Australia
- College of Medicine and Public Health, Flinders University, Darwin, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- National Drug Research Institute, Curtin University, Melbourne, Australia
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Carey TA, Cibich M, Carey M, Hines S. Meet us where we are: non-Indigenous young peoples' ideas on how to reduce alcohol-related harm in Mparntwe (Alice Springs). Aust N Z J Public Health 2023; 47:100100. [PMID: 38035664 DOI: 10.1016/j.anzjph.2023.100100] [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: 01/21/2023] [Revised: 09/15/2023] [Accepted: 09/21/2023] [Indexed: 12/02/2023] Open
Abstract
OBJECTIVE This research sought to understand the strategies young people in a remote central Australian town believed would reduce alcohol-related harms amongst their peers. METHODS A total of 38 non-Indigenous residents of Mparntwe (Alice Springs), aged between 14 and 18 years, participated in focus groups at their school. Participants discussed strategies they thought would reduce alcohol-related harms among people their age. Data were analysed using thematic analysis. RESULTS Participants suggested that young peoples' drinking behaviour developed with peers. Through social learning in peer groups, drinking alcohol was perceived as fun and normal. Participants indicated a willingness to learn about strategies to stay safe around alcohol. Their ideas for doing so reflected their existing social methods of learning about alcohol: having comfortable conversations and storytelling with a small group of peers and a relatable role model. CONCLUSIONS Young residents of Mparntwe (Alice Springs) advised that alcohol-related harm reduction strategies would be most effective if focussed on safety, rather than abstinence, and applied social-learning strategies. IMPLICATIONS FOR PUBLIC HEALTH Young people value their burgeoning self-determination. Youth health interventions must engage youth in intervention co-design and aim to assist young people to make safer decisions, rather than making decisions on their behalf.
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Affiliation(s)
- Timothy A Carey
- WACHS Curtin Research and Innovation Alliance, Curtin University, Australia.
| | - Mikaela Cibich
- Flinders Rural and Remote Health, College of Medicine and Public Health, Flinders University, NT, Australia
| | - Margaret Carey
- Flinders Rural and Remote Health, College of Medicine and Public Health, Flinders University, NT, Australia
| | - Sonia Hines
- Flinders Rural and Remote Health, College of Medicine and Public Health, Flinders University, NT, Australia; Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
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Karriker-Jaffe KJ, Blackburn N, Graham K, Walker MJ, Room R, Wilson IM, Waleewong O, Gilchrist G, Ramsoomar L, Laslett AM. Can alcohol policy prevent harms to women and children from men's alcohol consumption? An overview of existing literature and suggested ways forward. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 119:104148. [PMID: 37540918 PMCID: PMC10734562 DOI: 10.1016/j.drugpo.2023.104148] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/17/2023] [Accepted: 07/23/2023] [Indexed: 08/06/2023]
Abstract
The World Health Organization's list of cost-effective alcohol control policies is a widely-used resource that highlights strategies to address alcohol-related harms. However, there is more evidence on how recommended policies impact harms to people who drink alcohol-such as physical health problems caused by heavy alcohol use-than on secondhand harms inflicted on someone other than the person drinking alcohol, i.e., alcohol's harms to others. In this essay, we describe evidence of impacts of alcohol policy on harms to women and children resulting from men's alcohol consumption, as well as options for making policies more relevant for reducing intimate partner violence and child abuse. We begin with an overview of harms to women and children resulting from men's alcohol consumption and review cost-effective alcohol policies with potential to reduce these harms based on likely mechanisms of action. Next, we present a rapid review of reviews to describe existing evidence of impacts of these policies on the outcomes of physical violence, sexual violence, and child abuse and neglect. We found little evidence of systematic evaluation of impacts of these important alcohol policies on harms to women and children. Thus, we advocate for increased attention in evaluation research to the impacts of alcohol policies on harms experienced by women and children who are exposed to men who drink alcohol. We also argue for more consideration of a broader range of policies and interventions to reduce these specific types of harm. Finally, we present a conceptual model illustrating how alcohol policies may be supplemented with other interventions specifically tailored to reduce alcohol-related harms commonly experienced by women and children as a result of men's alcohol use.
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Affiliation(s)
| | - Natalie Blackburn
- Center for Health Behavior & Implementation Science, RTI International, Berkeley, CA, USA
| | - Kathryn Graham
- Institute for Mental Health Policy Research, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, London/Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mary Jean Walker
- Department of Politics, Media, & Philosophy, La Trobe University, Melbourne, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Centre for Social Research on Alcohol & Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Ingrid M Wilson
- Health & Social Sciences, Singapore Institute of Technology, Singapore; Judith Lumley Centre, La Trobe University, Australia
| | - Orratai Waleewong
- International Health Policy Program, Ministry of Public Health, Thailand
| | - Gail Gilchrist
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Leane Ramsoomar
- Gender & Health Research Unit, South African Medical Research Council, Pretoria, South Africa; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; School of Public Health & Health Systems, University of the Pretoria, Gauteng, South Africa
| | - Anne-Marie Laslett
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Australia
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Holland L, Reid N, Hewlett N, Toombs M, Elisara T, Thomson A, Humphrey T, Smirnov A. Alcohol use in Australia: countering harm with healing. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 37:100774. [PMID: 37693874 PMCID: PMC10485668 DOI: 10.1016/j.lanwpc.2023.100774] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/22/2023] [Accepted: 04/13/2023] [Indexed: 09/12/2023]
Abstract
Harmful use of alcohol consumption in Australia is a serious socio-political and public health issue that is exacerbated by exploitative marketing campaigns by the alcohol industry. In Indigenous populations harmful alcohol use is directly related to the legacy of colonisation that has led to complex social issues and adverse intergenerational trauma. To effectively address alcohol-related harm in Australia, it is necessary to critically apply the 'Three Pillars of Harm Minimisation', which are demand reduction, supply reduction, and harm reduction. This can be facilitated through approaches such as the 'Interplay Wellbeing Framework', which situates concepts of wellbeing and risky alcohol use within the context of systemic inequities across all social determinants of health. Culturally responsive approaches embody a holistic view of community, mutually respectful collaboration, culture, healing, and self-determined change. This is underpinned by Indigenous leadership that promotes existing resistance, resilience, interpersonal relationships, and strengths that instil healing to counter the harms associated with alcohol use.
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Affiliation(s)
- Lorelle Holland
- School of Nursing, Midwifery and Social Work, The Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland 4006, Australia
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, 62 Graham Street, South Brisbane, Queensland 4101, Australia
| | - Natasha Reid
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, 62 Graham Street, South Brisbane, Queensland 4101, Australia
| | - Nicole Hewlett
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, 62 Graham Street, South Brisbane, Queensland 4101, Australia
| | - Maree Toombs
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Fisher Road, Camperdown, New South Wales 2006, Australia
| | - Tylissa Elisara
- School of Nursing, Midwifery and Social Work, The Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland 4006, Australia
| | - Amy Thomson
- School of Education, Faculty of Humanities and Social Sciences, The University of Queensland, St Lucia, Queensland 4006, Australia
| | - Tracy Humphrey
- Faculty of Health and Behavioural Sciences, The University of South Australia, 101 Currie St, Adelaide 5000, Australia
| | - Andrew Smirnov
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland 4006, Australia
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Crocetti AC, Cubillo Larrakia B, Walker Yorta Yorta T, Mitchell Mununjali F, Paradies Wakaya Y, Backholer K, Browne J. 'A recipe for cultural disaster!'- a case study of Woolworths Group's proposal to build an alcohol megastore in Darwin, Northern Territory. Global Health 2023; 19:38. [PMID: 37301864 DOI: 10.1186/s12992-023-00938-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The health and wellbeing impacts of commercial activity on Indigenous populations is an emerging field of research. The alcohol industry is a key driver of health and social harms within Australia. In 2016 Woolworths, the largest food and beverage retailer in Australia, proposed to build a Dan Murphy's alcohol megastore in Darwin, near three 'dry' Aboriginal communities. This study examines the tactics used by Woolworths to advance the Dan Murphy's proposal and understand how civil society action can overcome powerful commercial interests to protect Aboriginal and Torres Strait Islander health and wellbeing. METHODS Data from 11 interviews with Aboriginal and non-Aboriginal informants were combined with data extracted from media articles and government, non-government and industry documents. Thematic analysis was informed by an adapted corporate health impact assessment framework. RESULTS Woolworths employed several strategies including lobbying, political pressure, litigation, and divisive public rhetoric, while ignoring the evidence suggesting the store would increase alcohol-related harm. The advocacy campaign against the proposal highlighted the importance of Aboriginal and non-Aboriginal groups working together to counter commercial interests and the need to champion Aboriginal leadership. Advocacy strategies included elevating the voices of community Elders in the media and corporate activism via Woolworths' investors. CONCLUSIONS The strategies used by the coalition of Aboriginal and non-Aboriginal groups may be useful in future advocacy campaigns to safeguard Aboriginal and Torres Strait Islander health and wellbeing from commercial interests.
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Affiliation(s)
- Alessandro Connor Crocetti
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia.
| | - Beau Cubillo Larrakia
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Troy Walker Yorta Yorta
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | | | - Yin Paradies Wakaya
- Deakin University, Alfred Deakin Institute for Citizenship and Globalisation, Burwood, VIC, Australia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Jennifer Browne
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia
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Taylor N. Three years of minimum unit pricing in the Northern Territory, what does the evidence say? Drug Alcohol Rev 2023; 42:912-914. [PMID: 36917512 DOI: 10.1111/dar.13641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/16/2023]
Affiliation(s)
- Nicholas Taylor
- National Drug Research Institute, Curtin University, Melbourne, Australia.,School of Psychology, Deakin University, Geelong, Australia.,The Burnet Institute, Melbourne, Australia
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12
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Brownlea S, Miller J, Taylor N, Miller P, Coomber K, Baldwin R, Palmer D. Impact of alcohol policy changes on substance‐affected patients attending an emergency department in the Northern Territory with police. Emerg Med Australas 2022; 35:390-397. [PMID: 36428244 DOI: 10.1111/1742-6723.14126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/04/2022] [Accepted: 10/18/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Assess the impact of Northern Territory alcohol policy changes to ED utilisation at Royal Darwin-Palmerston Regional Hospitals. METHODS Interrupted time series analysis explored trends in monthly ED attendance numbers and the proportion self-discharging prior to policy changes (September 2016 to August 2017) and after three sequential interventions; the Banned Drinker Register, introduced September 2017, system changes to the sobering shelter, January 2018, and the minimum unit floor price (MUFP), October 2018. A targeted cohort of attendances transported by police as an alternative to the sobering shelter or police watch-house when there is a medical concern was selected as they are likely impacted by all policy changes. RESULTS Police transported 1176 patients on 2070 occasions from September 2016 to March 2019. There was a downward trend in monthly attendances across the study period, with no significant change attributable to the Banned Drinker Register, a significant step decrease with the sobering shelter changes (P = 0.002), and a significant gradual decrease following the MUFP (P = 0.025). This represented an immediate decrease of 3.82 attendances per month/10 000 residents following the sobering shelter changes and a gradual decrease of 0.92 attendances/10 000 residents after the MUFP. Rates of self-discharge were high, 45% in the pre-intervention phase, decreasing to 28% following the MUFP but this trend did not reach significance with any intervention. CONCLUSION The sequential introduction of broad sweeping alcohol policy changes introduced by the Northern Territory government was associated with significant reductions in ED utilisation. The proximity of the introduction of interventions creates difficulties identifying individual policy influence.
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Affiliation(s)
- Sandra Brownlea
- Top End Regional Health Service Royal Darwin and Palmerston Regional Hospitals Darwin Northern Territory Australia
| | - Justine Miller
- Top End Regional Health Service Royal Darwin and Palmerston Regional Hospitals Darwin Northern Territory Australia
| | - Nicholas Taylor
- School of Psychology Deakin University Geelong Victoria Australia
- National Drug Research Institute Curtin University Melbourne Victoria Australia
| | - Peter Miller
- School of Psychology Deakin University Geelong Victoria Australia
| | - Kerri Coomber
- School of Psychology Deakin University Geelong Victoria Australia
| | - Ryan Baldwin
- School of Psychology Deakin University Geelong Victoria Australia
| | - Didier Palmer
- Top End Regional Health Service Royal Darwin and Palmerston Regional Hospitals Darwin Northern Territory Australia
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Stearne AE, Lee KSK, Allsop S, Shakeshaft A, Wright M. First Nations Australians' experiences of current alcohol policy in Central Australia: evidence of self-determination? Int J Equity Health 2022; 21:127. [PMID: 36076199 PMCID: PMC9453735 DOI: 10.1186/s12939-022-01719-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
Alcohol is the leading cause of healthy years lost. There is significant variation in alcohol consumption patterns and harms in Australia, with those residing in the Northern Territory (NT), particularly First Nations Australians, experiencing higher alcohol-attributable harms than other Australians. Community leadership in the planning and implementation of health, including alcohol, policy is important to health outcomes for First Nations Australians. Self-determination, a cornerstone of the structural and social determinants of health, is necessary in the development of alcohol-related policy. However, there is a paucity of published literature regarding Indigenous Peoples self-determination in alcohol policy development. This study aims to identify the extent to which First Nations Australians experience self-determination in relation to current alcohol policy in Alice Springs/Mbantua (Northern Territory, Australia).Semi-structured qualitative yarns with First Nations Australian community members (n = 21) were undertaken. A framework of elements needed for self-determination in health and alcohol policy were applied to interview transcripts to assess the degree of self-determination in current alcohol policy in Alice Springs/Mbantua. Of the 36 elements, 33% were not mentioned in the interviews at all, 20% were mentioned as being present, and 75% were absent. This analysis identified issues of policy implementation, need for First Nations Australian leadership, and representation.Alcohol policy for First Nations Australians in the NT is nuanced and complicated. A conscious approach is needed to recognise and implement the right to self-determination, which must be led and defined by First Nations Australians.First Nations Australians' experiences of current alcohol policy in Central Australia: evidence of self-determination?
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Affiliation(s)
- Annalee E. Stearne
- National Drug Research Institute and enAble Institute, Faculty of Health Sciences, Curtin University, WA Perth, Australia
| | - KS Kylie Lee
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Sydney, NSW Australia
| | - Steve Allsop
- National Drug Research Institute and enAble Institute, Faculty of Health Sciences, Curtin University, WA Perth, Australia
| | - Anthony Shakeshaft
- University of New South Wales, National Drug and Alcohol Research Centre, Sydney, NSW Australia
| | - Michael Wright
- Faculty of Health Sciences, School of Allied Health, Curtin University, WA 6845 Perth, Australia
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Stearne AE, Lee KK, Allsop S, Shakeshaft A, Wright M. Self-determination by First Nations Australians in alcohol policy: Lessons from Mbantua/Alice Springs (Northern Territory, Australia). THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 108:103822. [PMID: 35985205 DOI: 10.1016/j.drugpo.2022.103822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/25/2022] [Accepted: 08/07/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND First Nations Australians have an internationally-recognised right to self-determination - a key social determinant of health. The recognition and application of this right varies within different regions and policy contexts but is currently unknown for First Nations Australians' engagement in alcohol policy development. This study seeks to: explore First Nations Australians' experiences of alcohol policy in Central Australia (Northern Territory); and identify how First Nations Australians' right to self-determination can be recognised and applied in the development of alcohol policy in Mbantua/Alice Springs. METHODS Using a blended yarning and appreciative inquiry approach, 24 interviews were conducted. Interviews were thematically coded in multiple stages, using diagrammatic methods. RESULTS Four key themes emerged: (i) experiences of purchasing alcohol; (ii)communication of the current alcohol policy; (iii) experiences of policy described by participants (and their community); and (iv) self-determination in alcohol policy. CONCLUSIONS Current pathways for contributing to alcohol policy have been ineffective in achieving meaningful engagement with Australia's First Nations community members. This study provides some guidance as to how self-determination can more effectively be incorporated in the development of alcohol policy in the NT.
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Affiliation(s)
- Annalee E Stearne
- Curtin University, Faculty of Health Sciences, National Drug Research Institute, Perth, 6845, Western Australia, Australia; Curtin University, Faculty of Health Sciences, enAble Institute, Perth, 6845, Western Australia, Australia.
| | - Ks Kylie Lee
- Curtin University, Faculty of Health Sciences, National Drug Research Institute, Perth, 6845, Western Australia, Australia; Curtin University, Faculty of Health Sciences, enAble Institute, Perth, 6845, Western Australia, Australia; The University of Sydney, Faculty of Medicine and Health, Central Clinical School, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Sydney, New South Wales, Australia; The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, New South Wales, Australia; Burnet Institute, Melbourne, Victoria, Australia; La Trobe University, Centre for Alcohol Policy Research, Melbourne, Victoria, Australia
| | - Steve Allsop
- Curtin University, Faculty of Health Sciences, National Drug Research Institute, Perth, 6845, Western Australia, Australia; Curtin University, Faculty of Health Sciences, enAble Institute, Perth, 6845, Western Australia, Australia
| | - Anthony Shakeshaft
- University of New South Wales, National Drug and Alcohol Research Centre, Sydney, New South Wales, Australia
| | - Michael Wright
- Curtin University, Faculty of Health Sciences, School of Occupational Therapy, Social Work and Speech Pathology, 6845, Western Australia, Australia
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Martin K, Hines S, Carey TA. Alcohol restrictions in Australia: why are we not listening to the people who matter? JBI Evid Synth 2022; 20:1608-1609. [PMID: 36164712 DOI: 10.11124/jbies-22-00244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Kathleen Martin
- Flinders University Rural and Remote Health, Casuarina, NT, Australia
| | - Sonia Hines
- Flinders University Rural and Remote Health, Casuarina, NT, Australia.,Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
| | - Timothy A Carey
- Charles Darwin University, Casuarina, NT, Australia.,University of Newcastle, Newcastle, NSW, Australia
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Hodgetts K, Kleinecke M, Woerle C, Kaestli M, Budd R, Webb JR, Ward L, Mayo M, Currie BJ, Meumann EM. Melioidosis in the remote Katherine region of northern Australia. PLoS Negl Trop Dis 2022; 16:e0010486. [PMID: 35696415 PMCID: PMC9232150 DOI: 10.1371/journal.pntd.0010486] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/24/2022] [Accepted: 05/10/2022] [Indexed: 11/19/2022] Open
Abstract
Melioidosis is endemic in the remote Katherine region of northern Australia. In a population with high rates of chronic disease, social inequities, and extreme remoteness, the impact of melioidosis is exacerbated by severe weather events and disproportionately affects First Nations Australians. All culture-confirmed melioidosis cases in the Katherine region of the Australian Top End between 1989–2021 were included in the study, and the clinical features and epidemiology were described. The diversity of Burkholderia pseudomallei strains in the region was investigated using genomic sequencing. From 1989–2021 there were 128 patients with melioidosis in the Katherine region. 96/128 (75%) patients were First Nations Australians, 72/128 (56%) were from a very remote region, 68/128 (53%) had diabetes, 57/128 (44%) had a history of hazardous alcohol consumption, and 11/128 (9%) died from melioidosis. There were 9 melioidosis cases attributable to the flooding of the Katherine River in January 1998; 7/9 flood-associated cases had cutaneous melioidosis, five of whom recalled an inoculating event injury sustained wading through flood waters or cleaning up after the flood. The 126 first-episode clinical B. pseudomallei isolates that underwent genomic sequencing belonged to 107 different sequence types and were highly diverse, reflecting the vast geographic area of the study region. In conclusion, melioidosis in the Katherine region disproportionately affects First Nations Australians with risk factors and is exacerbated by severe weather events. Diabetes management, public health intervention for hazardous alcohol consumption, provision of housing to address homelessness, and patient education on melioidosis prevention in First Nations languages should be prioritised. Melioidosis, caused by the environmental bacterium Burkholderia pseudomallei, disproportionately affects Australian First Nations peoples in the Northern Territory of Australia. The Katherine region has some of the highest rates of homelessness in Australia, and social inequity impacts health outcomes for First Nations people whose access to care is further complicated by remoteness. In this study, we describe the clinical features and epidemiology of melioidosis in the Katherine region over a 32-year period. Almost three quarters of melioidosis cases were First Nations Australians, over half lived in a very remote region, and diabetes and hazardous alcohol consumption were common risk factors. Following a severe flooding event in the region in 1998, a spike in cases of melioidosis was seen, the majority presenting as skin and soft tissue infections. The B. pseudomallei isolates in the study were extremely genetically diverse, reflecting the large geographic area of the Katherine region. With predicted climate change-driven increases in severe weather events and subsequent increases in melioidosis cases, public health priorities in the region should include addressing high rates of homelessness and hazardous alcohol consumption, optimisation of diabetes management, and ongoing education in First Nations languages regarding prevention of B. pseudomallei exposure.
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Affiliation(s)
- Kay Hodgetts
- Department of Infectious Diseases, Wellington Regional Hospital, Wellington, New Zealand
- Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Mariana Kleinecke
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Celeste Woerle
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Mirjam Kaestli
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Richard Budd
- Katherine District Hospital, Katherine, Northern Territory, Australia
| | - Jessica R. Webb
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Department of Microbiology & Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Linda Ward
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Mark Mayo
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Bart J. Currie
- Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Ella M. Meumann
- Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- * E-mail:
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Miller P, Coomber K, Smith J, Livingston M, Stevens M, Guthridge S, Room R, Wright CJC, Rung D, Clifford S, Baldwin R, Das S, Paradies Y, Scott D, Griffiths KE, Farmer C, Mayshak R, Silver B, Moore S, Mack J, Mithen V, Dyall D, Ward J, Boffa J, Chikritzhs T. Learning from alcohol (policy) reforms in the Northern Territory (LEARNT): protocol for a mixed-methods study examining the impacts of the banned drinker register. BMJ Open 2022; 12:e058614. [PMID: 35365540 PMCID: PMC8977786 DOI: 10.1136/bmjopen-2021-058614] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The Banned Drinker Register (BDR) was reintroduced in the Northern Territory (NT) in September 2017. The BDR is a supply reduction measure and involves placing people who consume alcohol at harmful levels on a register prohibiting the purchase, possession and consumption of alcohol. The current study aims to evaluate the impacts of the reintroduction of the BDR, in the context of other major alcohol policy initiatives introduced across the NT such as Police Auxiliary Liquor Inspectors and a minimum unit price for alcohol of US$1.30 per standard drink. METHODS AND ANALYSES The Learning from Alcohol (policy) Reforms in the Northern Territory project will use a mixed-methods approach and contain four major components: epidemiological analysis of trends over time (outcomes include health, justice and social welfare data); individual-level data linkage including those on the BDR (outcomes include health and justice data); qualitative interviews with key stakeholders in the NT (n≥50); and qualitative interviews among people who are, or were previously, on the BDR, as well as the families and communities connected to those on the BDR (n=150). The impacts of the BDR on epidemiological data will be examined using time series analysis. Linked data will use generalised mixed models to analyse the relationship between outcomes and exposures, utilising appropriate distributions. Qualitative data will be analysed using thematic analysis. ETHICS AND DISSEMINATION Ethics approvals have been obtained from NT Department of Health and Menzies School of Health Research Human Research Ethics Committee (HREC), Central Australia HREC and Deakin University HREC. In addition to peer-reviewed publications, we will report our findings to key organisational, policy, government and community stakeholders via conferences, briefings and lay summaries.
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Affiliation(s)
| | | | - James Smith
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Michael Livingston
- Curtin University, Perth, Western Australian, Australia
- La Trobe University, Melbourne, Victoria, Australia
| | - Matthew Stevens
- Well-being and Preventable Chronic Disease, Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Steven Guthridge
- Child Development, Population Health and Policy, Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Robin Room
- La Trobe University, Melbourne, Victoria, Australia
| | | | - Daile Rung
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Sarah Clifford
- Charles Darwin University, Casuarina, Northern Territory, Australia
| | | | - Sumon Das
- Child Health Division, Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Yin Paradies
- Faculty of Arts and Education, Deakin University, Burwood, Victoria, Australia
| | - Debbie Scott
- Turning Point, Monash University Eastern Health Clinical School, North Richmond, Victoria, Australia
- Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Kalinda E Griffiths
- Charles Darwin University, Casuarina, Northern Territory, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | | | | | - Bronwyn Silver
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Sam Moore
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Jordan Mack
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Vincent Mithen
- Aboriginal Medical Services Alliance Northern Territory, Darwin, Northern Territory, Australia
| | - Danielle Dyall
- Aboriginal Medical Services Alliance Northern Territory, Darwin, Northern Territory, Australia
| | - J Ward
- University of Queensland, Brisbane, Queensland, Australia
| | - John Boffa
- Central Australian Aboriginal Congress, Alice Springs, Australian Capital Territory, Australia
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
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