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Freeman T, Mackean T, Sherwood J, Ziersch A, O’Donnell K, Dwyer J, Askew D, Shakespeare M, D’Angelo S, Fisher M, Browne A, Egert S, Baghbanian V, Baum F. The Benefits of Cooperative Inquiry in Health Services Research: Lessons from an Australian Aboriginal and Torres Strait Islander Health Study. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2024; 54:171-182. [PMID: 38146191 PMCID: PMC10955798 DOI: 10.1177/27551938231221757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/17/2023] [Accepted: 11/01/2023] [Indexed: 12/27/2023]
Abstract
Health services research is underpinned by partnerships between researchers and health services. Partnership-based research is increasingly needed to deal with the uncertainty of global pandemics, climate change induced severe weather events, and other disruptions. To date there is very little data on what has happened to health services research during the COVID-19 pandemic. This paper describes the establishment of an Australian multistate Decolonising Practice research project and charts its adaptation in the face of disruptions. The project used cooperative inquiry method, where partner health services contribute as coresearchers. When the COVID-19 pandemic hit, data collection needed to be immediately paused, and when restrictions started to lift, all research plans had to be renegotiated with services. Adapting the research surfaced health service, university, and staffing considerations. Our experience suggests that cooperative inquiry was invaluable in successfully navigating this uncertainty and negotiating the continuance of the research. Flexible, participatory methods such as cooperative inquiry will continue to be vital for successful health services research predicated on partnerships between researchers and health services into the future. They are also crucial for understanding local context and health services priorities and ways of working, and for decolonising Indigenous health research.
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Affiliation(s)
- Toby Freeman
- Stretton Health Equity, The University of Adelaide, Adelaide, Australia
| | - Tamara Mackean
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | | | - Anna Ziersch
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Kim O’Donnell
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Judith Dwyer
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | | | - Madison Shakespeare
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Shane D’Angelo
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Matthew Fisher
- Stretton Health Equity, The University of Adelaide, Adelaide, Australia
| | - Annette Browne
- The University of British Columbia Faculty of Applied Science, Vancouver, Canada
| | - Sonya Egert
- Southern Qld Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care - Inala Indigenous Health, Queensland Health, Inala, Australia
| | - Vahab Baghbanian
- Central Australian Aboriginal Congress, Alice Springs, Australia
| | - Fran Baum
- Stretton Health Equity, The University of Adelaide, Adelaide, Australia
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Gidgup MJR, Kickett M, Francis-Coad J, Hill K, Umbella J, Coombes J, Ivers R, Bowser N, Palacios V, Hill AM. 'Nih Waangkiny Kaadatjiny': 'Listening, learning and knowing': Stakeholders' perspectives about barriers and enablers to delivering a successful physical activity program for older Aboriginal people. Health Promot J Austr 2024; 35:444-456. [PMID: 37489774 DOI: 10.1002/hpja.774] [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: 09/23/2022] [Revised: 05/19/2023] [Accepted: 06/26/2023] [Indexed: 07/26/2023] Open
Abstract
There is limited evidence about how physical activity (PA) programs should be provided for older Aboriginal and Torres Strait Islander peoples. Recently two groups of Aboriginal Elders on Noongar Boodja (Country) in Western Australia participated in the Ironbark PA program. ISSUE ADDRESSED The objective of this study was to explore the views of key stakeholders about the barriers and enablers to delivering a successful PA program and provide feedback for future program delivery. METHODS The research took a 'Nih (listening), Waangkiny (learning), Kaadatjiny (knowing)' approach. The lead researcher, a Noongar Wadjuk woman, conducted semi-structured interviews (n = 17) with key stakeholders: Aboriginal and non-Aboriginal workers who assisted to deliver the program, and family and local members of the communities. Data were also collected through weekly program notes and researcher diary entries. Data were analysed thematically. RESULTS The overarching theme highlighted that stakeholders felt a sense of building a PA program that was culturally appropriate. They reflected that the program attracted older Aboriginal people because it was designed to make them feel welcomed with a sense of belonging. Five major themes were identified: Relationships, Belonging, Program structure, Benefits of the program and Future planning. Positive changes observed in Elders' health and well-being were a source of inspiration for team workers. CONCLUSIONS Key enablers to delivering a PA program for older Aboriginal people are building a culturally strong program that creates a sense of belonging for the participants. SO WHAT?: Practitioners who are planning PA programs for older Aboriginal people should prioritise the development of cultural safety and security.
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Affiliation(s)
- Margaret J R Gidgup
- School of Allied Health, Faculty of Health Science, Curtin University, Perth, Australia
- School of Allied Health, WA Centre for Health and Ageing, The University of Western Australia, Perth, Australia
| | | | - Jacqueline Francis-Coad
- School of Allied Health, WA Centre for Health and Ageing, The University of Western Australia, Perth, Australia
| | - Keith Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Josephine Umbella
- School of Allied Health, WA Centre for Health and Ageing, The University of Western Australia, Perth, Australia
| | | | - Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Nicole Bowser
- South West Aboriginal Medical Service Aboriginal Corporation, Bunbury, Australia
| | | | - Anne-Marie Hill
- School of Allied Health, WA Centre for Health and Ageing, The University of Western Australia, Perth, Australia
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Reath JS, O'Brien S, Campbell L, Gunasekera H, Tyson CA, Askew DA, Hu W, Usherwood T, Kong K, Morris P, Leach AJ, Walsh R, Abbott PA. The views of parents and carers on managing acute otitis media in urban Aboriginal and Torres Strait Islander children: a qualitative study. Med J Aust 2024; 220:202-207. [PMID: 38266503 DOI: 10.5694/mja2.52217] [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: 05/11/2023] [Accepted: 11/06/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES To explore the views of parents and carers regarding the management of acute otitis media in urban Aboriginal and Torres Strait Islander children who are at low risk of complications living in urban communities. STUDY DESIGN Qualitative study; semi-structured interviews and short telephone survey. SETTING, PARTICIPANTS Interviews: purposive sample of parents and carers of urban Aboriginal and Torres Strait Islander children (18 months - 16 years old) screened in Aboriginal medical services in Queensland, New South Wales, and Canberra for the WATCH study, a randomised controlled trial that compared immediate antibiotic therapy with watchful waiting for Aboriginal and Torres Strait Islander children with acute otitis media. SURVEY parents and carers recruited for the WATCH trial who had completed week two WATCH surveys. RESULTS We interviewed twenty-two parents and carers, including ten who had declined participation in or whose children were ineligible for the WATCH trial. Some interviewees preferred antibiotics for managing acute otitis media, others preferred watchful waiting, expressing concerns about side effects and reduced efficacy with overuse of antibiotics. Factors that influenced this preference included the severity, duration, and recurrence of infection, and knowledge about management gained during the trial and from personal and often multigenerational experience of ear disease. Participants highlighted the importance of shared decision making by parents and carers and their doctors. Parents and carers of 165 of 262 WATCH participants completed telephone surveys (63%); 81 were undecided about whether antibiotics should always be used for treating acute otitis media. Open-ended responses indicated that antibiotic use should be determined by clinical need, support for general practitioners' decisions, and the view that some general practitioners prescribed antibiotics too often. CONCLUSIONS Parents and carers are key partners in managing acute otitis media in urban Aboriginal and Torres Strait Islander children. Our findings support shared decision making informed by the experience of parents and carers, which could also lead to reduced antibiotic use for managing acute otitis media.
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Affiliation(s)
| | - Sarah O'Brien
- Western Sydney University, Penrith, NSW
- Murrumbidgee Local Health District, Wagga Wagga, NSW
| | - Letitia Campbell
- Western Sydney University, Penrith, NSW
- Coomera Clinic, Kalwun Development Corporation, Coomera, QLD
| | | | - Claudette A Tyson
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Metro South Health, Brisbane, QLD
| | | | - Wendy Hu
- Western Sydney University, Penrith, NSW
| | - Tim Usherwood
- Sydney Medical School, University of Sydney, Westmead, NSW
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Owen KJ, Cundale K, Hughes JT, McDonald SP, D'Antoine M, Jesudason S. From talk to action: Indigenous Reference Groups drive practice change in kidney transplantation care. Med J Aust 2023; 219 Suppl 8:S15-S18. [PMID: 37839028 DOI: 10.5694/mja2.52102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/14/2023] [Indexed: 10/17/2023]
Affiliation(s)
- Kelli J Owen
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA
- Adelaide Medical School, University of Adelaide, Adelaide, SA
| | - Katie Cundale
- National Indigenous Kidney Transplantation Taskforce, South Australian Health and Medical Research Institute, Adelaide, SA
| | - Jaquelyne T Hughes
- Rural and Remote Health, Flinders University, Darwin, NT
- Royal Darwin Hospital, Darwin, NT
| | - Stephen P McDonald
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA
- Adelaide Medical School, University of Adelaide, Adelaide, SA
| | - Matilda D'Antoine
- National Indigenous Kidney Transplantation Taskforce, South Australian Health and Medical Research Institute, Adelaide, SA
| | - Shilpanjali Jesudason
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA
- Adelaide Medical School, University of Adelaide, Adelaide, SA
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Moloney A, Stuart L, Chen Y, Lin F. Healthcare professionals' cultural safety practices for indigenous peoples in the acute care setting - a scoping review. Contemp Nurse 2023; 59:272-293. [PMID: 37864826 DOI: 10.1080/10376178.2023.2271576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/11/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND For Indigenous Peoples the disparities in health status are largely associated with the direct social determinants of invasion and colonisation, marginalisation, intergenerational traumas, and lack of conscious government policy to address these ongoing effects. There is currently limited evidence in the literature on what Cultural Safety practices mean in acute care settings. OBJECTIVE We aimed to understand the extent and type of evidence in relation to current knowledge and evidence regarding Cultural Safety practices for Indigenous Peoples in acute care settings. DESIGN This is a scoping review. METHODS We searched six databases in consultation with a librarian experienced in health research. RESULTS A total of 16 papers were included in the scoping review. Four main barriers to Cultural Safety in practice were identified; Among the included studies, only one quality improvement study reported an intervention, which improved culturally safe care. CONCLUSION The four barriers identified each have a variable impact on Indigenous Peoples' health outcomes and are dependent upon the circumstances and experiences of both Indigenous Peoples and healthcare professionals.
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Affiliation(s)
- Ali Moloney
- School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Lynne Stuart
- School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Yingyan Chen
- School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Frances Lin
- School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Rooney EJ, Wilson RL, Johnson A. Integration of traditional therapies for first nations people within western healthcare: an integrative review. Contemp Nurse 2023; 59:294-310. [PMID: 37939110 DOI: 10.1080/10376178.2023.2276718] [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: 03/13/2023] [Accepted: 10/24/2023] [Indexed: 11/10/2023]
Abstract
AIMS To conduct an integrative literature review to reveal any evidence supportive of the integration of traditional therapies for First Nations peoples in Australia within a western healthcare model, and to identify which, if any, of these therapies have been linked to better health outcomes and culturally safe and appropriate care for First Nations peoples. If so, are there indications by First Nations peoples in Australia that these have been effective in providing culturally safe care or the decolonisation of western healthcare practices. DESIGN Integrative literature review of peer-reviewed literature. DATA SOURCES Online databases searched included CINAHL, Medline, Scopus, ScienceDirect InformitHealth, and ProQuest. REVIEW METHODS Databases were searched for papers with full text available and published in English with no date parameter set. The PRISMA guidelines were used during the literature review and the literature was critiqued using the Critical Appraisal Skills tool. RESULTS Seven articles met the inclusion criteria and were included in the review. Four articles selected were qualitative, two used a mixed method design, and one used a quantitative method. Six themes arose: (i) bush medicine, (ii) traditional healers, (iii) traditional healing practices, (iv) bush tucker, (v) spiritual healing, and (vi) therapies that connected to cultures such as yarning and storytelling. CONCLUSION There is limited literature discussing the use of traditional therapies in Western healthcare settings. A need exists to include traditional therapies within a Western healthcare system. Creating a culturally safer and appropriate healthcare experience for First Nations people in Australia and will contribute to advancement in the decolonisation of current healthcare models.
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Affiliation(s)
- Erin J Rooney
- School of Nursing and Midwifery, University of Newcastle, Gosford, Australia
| | - Rhonda L Wilson
- School of Nursing and Midwifery, University of Newcastle, Gosford, Australia
- School of Nursing, Massey University, Palmerston North, New Zealand
| | - Amanda Johnson
- School of Nursing and Midwifery, University of Newcastle, Gosford, Australia
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Culbong H, Ramirez-Watkins A, Anderson S, Culbong T, Crisp N, Pearson G, Lin A, Wright M. "Ngany Kamam, I Speak Truly": First-Person Accounts of Aboriginal Youth Voices in Mental Health Service Reform. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6019. [PMID: 37297622 PMCID: PMC10253012 DOI: 10.3390/ijerph20116019] [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: 04/17/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023]
Abstract
Aboriginal young people are experts in their own experience and are best placed to identify the solutions to their mental health and wellbeing needs. Given that Aboriginal young people experience high rates of mental health concerns and are less likely than non-Indigenous young people to access mental health services, co-design and evaluation of appropriate mental health care is a priority. Increasing Aboriginal young people's participation in mental health service reform is key to ensuring services are culturally secure, relevant and accessible. This paper presents first-person accounts from three Aboriginal young people who worked alongside their Elders and in a positive and constructive partnership with mainstream mental health services on a three-year participatory action research project in Perth, Western Australia, in Whadjuk Nyoongar boodja (Country). The young people recount their experiences as participants and co-researchers on a systems change mental health research project and share their views on the importance of privileging Aboriginal youth voices. Their accounts highlight that Aboriginal young people's participation and leadership must be understood through a decolonising lens and that working in genuine partnership with the community is key to increasing their contact and engagement with mental health care and improving mental health and wellbeing outcomes.
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Affiliation(s)
- Hunter Culbong
- College of Arts and Social Sciences, Australian National University, Canberra 2601, Australia;
| | | | - Shae Anderson
- Kulbardi Aboriginal Centre, Murdoch University, Perth 6150, Australia;
| | - Tiana Culbong
- School of Nursing and Midwifery, The University of Technology, Sydney 2000, Australia;
| | - Nikayla Crisp
- Design Participation and Inclusion, Neami National, Perth 6000, Australia;
| | - Glenn Pearson
- Telethon Kids Institute, University of Western Australia, Perth 6000, Australia; (G.P.); (A.L.)
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Perth 6000, Australia; (G.P.); (A.L.)
| | - Michael Wright
- School of Allied Health, Faculty of Health Sciences, Curtin University, Bentley 6102, Australia
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McCalman P, McLardie-Hore F, Newton M, McLachlan H, Forster D. Trust, privacy, community, and culture: Important elements of maternity care for Aboriginal and Torres Strait Islander women giving birth in Victoria. Women Birth 2023; 36:e150-e160. [PMID: 35803869 DOI: 10.1016/j.wombi.2022.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/10/2022] [Accepted: 06/06/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The Australian maternity system must enhance its capacity to meet the needs of Aboriginal and Torres Strait Islander (First Nations) mothers and babies, however evidence regarding what is important to women is limited. AIMS The aim of this study was to explore what women having a First Nations baby rate as important for their maternity care as well as what life stressors they may be experiencing. METHODS Women having a First Nations baby who booked for care at one of three urban Victorian maternity services were invited to complete a questionnaire. RESULTS 343 women from 76 different language groups across Australia. Almost one third of women reported high levels of psychological distress, mental illness and/or were dealing with serious illness or death of relatives or friends. Almost one quarter reported three or more coinciding life stressors. Factors rated as most important were privacy and confidentiality (98 %), feeling that staff were trustworthy (97 %), unrestricted access to support people during pregnancy appointments, (87 %) birth (66 %) and postnatally (75 %), midwife home visits (78 %), female carers (66 %), culturally appropriate artwork, brochures (68 %) and access to Elders (65 %). CONCLUSIONS This study provides important information about what matters to women who are having a First Nations baby in Victoria, Australia, bringing to the forefront social and cultural complexities experienced by many women that need to be considered in programme planning. It is paramount that maternity services partner with First Nations communities to implement culturally secure programmes that respond to the needs of local communities.
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Affiliation(s)
- P McCalman
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3052 Australia.
| | - F McLardie-Hore
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; The Royal Women's Hospital, Parkville, Victoria 3052 Australia
| | - M Newton
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3052 Australia
| | - H McLachlan
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3052 Australia
| | - D Forster
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; The Royal Women's Hospital, Parkville, Victoria 3052 Australia
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Asamoah GD, Khakpour M, Carr T, Groot G. Exploring Indigenous Traditional Healing programs in Canada, Australia, and New Zealand: A scoping review. Explore (NY) 2023; 19:14-25. [PMID: 35768321 DOI: 10.1016/j.explore.2022.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/12/2022] [Accepted: 06/06/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To explore and catalog ways Indigenous Traditional Healing practices are supported within the mainstream healthcare system through policies and programs in Canada, Australia, and New Zealand. DATA SOURCES A scoping review was conducted, guided by the PRISMA extension for Scoping Reviews. Databases for sources of information include CINAHL, Medline, Embase, Web of Science, Public Health ProQuest, Global Health EBSCO, iPortal, and grey literature. STUDY SELECTION 2 reviewers screened the titles and abstracts of the studies for inclusion against the selection criteria independently. Studies that met the inclusion criteria were transferred to Covidence for further abstract and full-text review. DATA EXTRACTION Of a total of 2,017 articles identified, 22 met the inclusion criteria for data extraction for this scoping review. Data items extracted include study title, authors, year of publication, publication type, publication source, support policy or program, health system or service, Indigenous Traditional Healing practices, and significant findings. DATA SYNTHESIS 2 categories emerged from the analysis of the source of evidence. That is, healthcare systems and services with programs and policies supporting Indigenous Traditional Healing practices, and ways Indigenous Traditional Healing was adopted and utilized within the identified support programs. CONCLUSIONS This study demonstrated the various ways Indigenous Traditional Healing practices are supported within the mainstream healthcare systems in Canada, Australia, and New Zealand. Indigenous Traditional Healing practices can be utilized as either the primary choice of treatment, to support Western biomedical treatment or through the adoption of Indigenous Traditional knowledge within the mainstream healthcare system.
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Affiliation(s)
- Gideon Darko Asamoah
- Department of Community Health and Epidemiology, University of Saskatchewan, Health Sciences Building, 107 Wiggins Road, Saskatoon SK, S7N 5E5, Canada.
| | - Mahasti Khakpour
- Interdisciplinary Health Program, St. Francis Xavier University, 110 A - Annex, PO Box 5000, Antigonish, Nova Scotia, B2G 2W5, Canada.
| | - Tracey Carr
- Department of Community Health and Epidemiology, University of Saskatchewan, Health Sciences Building, 107 Wiggins Road, Saskatoon SK, S7N 5E5, Canada.
| | - Gary Groot
- Department of Community Health and Epidemiology, University of Saskatchewan, Health Sciences Building, 107 Wiggins Road, Saskatoon SK, S7N 5E5, Canada.
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McBride K, Franks C, Wade V, King V, Rigney J, Burton N, Dowling A, Mitchell JA, Van Kessel G, Howard N, Paquet C, Hillier S, Nicholls SJ, Brown A. Getting to the heart of the matter: a research partnership with Aboriginal women in South and Central Australia. CRITICAL PUBLIC HEALTH 2022. [DOI: 10.1080/09581596.2022.2147417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Katharine McBride
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Christine Franks
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- Aboriginal Women’s Advisory Group, Adelaide, Australia
| | - Vicki Wade
- Aboriginal Women’s Advisory Group, Adelaide, Australia
- Menzies School of Health Research, Darwin, Australia
| | - Veronica King
- Aboriginal Women’s Advisory Group, Adelaide, Australia
- Central Australian Aboriginal Congress, Alice Springs, Australia
| | - Janice Rigney
- Aboriginal Women’s Advisory Group, Adelaide, Australia
| | - Nyunmiti Burton
- Aboriginal Women’s Advisory Group, Adelaide, Australia
- Ngaanyatjarra, Pitjantjatjara, Yankunytjatjara Women’s Council, Alice Springs, Australia
| | - Anna Dowling
- Aboriginal Women’s Advisory Group, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Julie Anne Mitchell
- Aboriginal Women’s Advisory Group, Adelaide, Australia
- The Heart Foundation of Australia, Sydney, Australia
| | - Gisela Van Kessel
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Natasha Howard
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- Indigenous Genomics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Catherine Paquet
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
- Faculté des Sciences de l’Administration, Université Laval, Québec, Canada
| | - Susan Hillier
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | | | - Alex Brown
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- Telethon Kids Institute and Australian National University, Adelaide, Australia
- Indigenous Genomics, Australian National University, Adelaide, Australia
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Sadler S, Gerrard J, West M, Lanting S, Charles J, Searle A, Chuter V. Aboriginal and Torres Strait Islander Peoples’ perceptions of foot and lower limb health: a systematic review. J Foot Ankle Res 2022; 15:55. [PMID: 35869536 PMCID: PMC9308327 DOI: 10.1186/s13047-022-00557-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Ongoing colonisation produces inequity in healthcare delivery and inequality in healthcare outcomes for Aboriginal and Torres Strait Islander Peoples. As a consequence, within the domain of lower limb health, foot disease has severe impacts for First Nations Peoples. Central to developing culturally safe healthcare and driving positive foot health change for First Nations Peoples, is the need for health professionals to develop understanding of First Nations perspectives of foot health. The aim of this systematic review was to evaluate studies investigating Aboriginal and Torres Strait Islander Peoples’ perceptions of foot and lower limb health.
Methods
PubMeD, Ovid (Embase, Emcare, Medline), CINAHL, Informit Indigenous collection, and grey literature sources were searched to 23rd July 2021. We included any published reports or studies that examined Aboriginal and Torres Strait Islander Peoples’ perceptions of foot and lower limb health, or meanings of, or attitudes to, foot and lower limb health.
Results
Four studies with a total of 1515 participants were included. Studies found that Aboriginal and Torres Strait Islander people self-assessed foot health with a demonstrated ability to perceive their feet as healthy relative to Western clinical measures of peripheral blood supply and neurological function. Footwear, including ill-fitting or lack of footwear was considered a contributing factor to reduced foot and lower limb health. Foot pain affected up to 60% of participants with up to 70% of foot pain untreated. Lack of access to culturally safe health care delivered by culturally capable health professionals was perceived to contribute to worse foot and lower limb health outcomes.
Conclusions
Aboriginal and Torres Strait Islander Peoples’ perceptions of foot and lower limb health are influenced by multiple complex interrelated factors. The limited number of studies in this area indicates ongoing failings to consult First Nations Peoples regarding their own lower limb and foot health. It is therefore essential that healthcare service and cultural capability implementation is led by Aboriginal and Torres Strait Islander Peoples in co-design. Urgent need for further research that exemplifies design and delivery of culturally safe care is required.
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Gidgup MJR, Kickett M, Hill KD, Francis‐Coad J, Weselman T, Coombes J, Ivers R, Bowser N, Palacios V, Hill A. Connecting and reconnecting to a community, with a sense of belonging - Exploring Aboriginal Elders' perspectives of engaging in a physical activity program. Health Promot J Austr 2022; 33 Suppl 1:138-149. [PMID: 35170128 PMCID: PMC9790223 DOI: 10.1002/hpja.582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 02/01/2022] [Accepted: 02/08/2022] [Indexed: 12/30/2022] Open
Abstract
ISSUE ADDRESSED Culturally appropriate physical activity (PA) programs have values and principles that respect local community culture and knowledge. However, in Western Australia (WA) there were no opportunities for older Aboriginal peoples to engage in a culturally appropriate PA program. The study objective was to explore how engaging in a culturally appropriate PA program impacted on the lived experiences of Aboriginal Elders. METHODS A qualitative exploratory study was conducted using an Indigenous methodology. Participants were Aboriginal Elders in Noongar Country in WA . Two groups, engaged in the Ironbark program, which consisted of weekly exercise and a yarning circle. The program was developed in NSW specifically for older Aboriginal and Torres Strait peoples and adapted for use in WA. Semi-structured interviews utilising a yarning approach were facilitated by a Noongar Wadjuk researcher. Inductive thematic analysis was undertaken. RESULTS Nineteen Elders were interviewed. The overarching theme was that participation led to connecting and reconnecting to community with a sense of belonging. Elders affirmed the program as being appropriate and comfortable. They described experiences that were grouped into three main themes of Positive mental and emotional changes, Physical improvements and Social benefits. CONCLUSIONS Aboriginal Elders valued the opportunity to engage in a culturally appropriate PA program. Benefits were appreciated as holistic in nature, with Elders seeing improvements in their mental, physical and emotional health. SO WHAT?: Increasing access to culturally appropriate, decolonised PA programs is a fundamental health promotion approach for working with older Aboriginal and Torres Strait Islander peoples.
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Affiliation(s)
- Margaret J. R. Gidgup
- School of Allied HealthFaculty of Health ScienceCurtin UniversityPerthWestern AustraliaAustralia,Centre for Aboriginal StudiesCurtin UniversityPerthWestern AustraliaAustralia
| | | | - Keith D. Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research CentreSchool of Primary and Allied Health CareMonash UniversityMelbourneVictoriaAustralia
| | | | - Tammy Weselman
- School of Allied HealthUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Julieann Coombes
- The George Institute for Global HealthSydneyNew South WalesAustralia
| | - Rebecca Ivers
- School of Population HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Nicole Bowser
- South West Aboriginal Medical Service Aboriginal CorporationBunbury Western AustraliaAustralia
| | - Vilma Palacios
- North Metropolitan Public Health UnitWA North Metropolitan Health ServicePerthWestern AustraliaAustralia
| | - Anne‐Marie Hill
- School of Allied HealthUniversity of Western AustraliaPerthWestern AustraliaAustralia
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Laccos-Barrett K, Brown AE, Saunders V, Baldock KL, West R. Are We Teaching Nurses to Be Racist towards Aboriginal and Torres Strait Islander Peoples? A Critical Race Document Analysis of Discrete Aboriginal and Torres Strait Islander Health Courses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11455. [PMID: 36141728 PMCID: PMC9517025 DOI: 10.3390/ijerph191811455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Racism is responsible for health inequity and the harm perpetrated upon Aboriginal and Torres Strait Islander peoples by white institutions, building on attitudes and beliefs dominated by assumptions of white superiority. The National Aboriginal and Torres Strait Islander Health Curriculum Framework 'Curriculum Framework', released in 2014, was introduced to provide a framework for nursing programs and included the introduction of discrete Aboriginal and Torres Strait Islander health courses to draw attention to the relationship between racism health outcomes of Aboriginal and Torres Strait Islander peoples within health care settings. METHODS Using an Indigenist research paradigm with Colonial Critical Race Theory as the methodology and framework, this study presents a document analysis of discrete Aboriginal and Torres Strait Islander health courses taught in undergraduate nursing programs at 31 Australian Universities. RESULTS This work draws on the collective activism of Aboriginal and Torres Strait Islander nurses in challenging the systemic racism embedded in the Australian nursing curriculum. We demonstrate the utility of the Racial Segregation Audit Tool (RSAT), as an innovative approach to identify and respond to racism embedded in course learning outcomes. CONCLUSIONS This study explores and uncovers how the learning outcomes assert the social construction of race as a tool of oppressive segregation.
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Affiliation(s)
- Keera Laccos-Barrett
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia
| | - Angela Elisabeth Brown
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Vicki Saunders
- Central Queensland University, Cairns, QLD 4870, Australia
| | | | - Roianne West
- Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, Murarrie, QLD 4172, Australia
- Workforce Innovation, Charles Darwin University, Darwin, NT 0810, Australia
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Reclaiming Indigenous Health in the US: Moving beyond the Social Determinants of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127495. [PMID: 35742745 PMCID: PMC9223447 DOI: 10.3390/ijerph19127495] [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: 03/18/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 02/01/2023]
Abstract
The lack of literature on Indigenous conceptions of health and the social determinants of health (SDH) for US Indigenous communities limits available information for Indigenous nations as they set policy and allocate resources to improve the health of their citizens. In 2015, eight scholars from tribal communities and mainstream educational institutions convened to examine: the limitations of applying the World Health Organization’s (WHO) SDH framework in Indigenous communities; Indigenizing the WHO SDH framework; and Indigenous conceptions of a healthy community. Participants critiqued the assumptions within the WHO SDH framework that did not cohere with Indigenous knowledges and epistemologies and created a schematic for conceptualizing health and categorizing its determinants. As Indigenous nations pursue a policy role in health and seek to improve the health and wellness of their nations’ citizens, definitions of Indigenous health and well-being should be community-driven and Indigenous-nation based. Policies and practices for Indigenous nations and Indigenous communities should reflect and arise from sovereignty and a comprehensive understanding of the nations and communities’ conceptions of health and its determinants beyond the SDH.
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Mohamed Shaburdin Z, Bourke L, Mitchell O, Newman T. 'It's a cultural thing': excuses used by health professionals on providing inclusive care. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2022; 31:1-15. [PMID: 34018893 DOI: 10.1080/14461242.2020.1846581] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 11/01/2020] [Indexed: 06/12/2023]
Abstract
Although health services in Australia have an aim to provide inclusive care for their patients/clients, this study highlights how barriers to care can lie at the centre of patient-provider interactions. Racial microaggression is a subtle form of racism that can occur in health settings, leading to further exclusion for First Nations Australians, immigrants and refugees. This paper is guided by Derrida's approach to deconstructionism by unpacking how language is used by health professionals - as holders of organisational power - and how they construct 'truths' or discourses about clients that historically have been marginalised by health services and system. Data comprise 21 interviews with staff from two rural health services. It identified three racial microaggressions were used to justify the challenges of providing care to people from First Nations, immigrant and refugee backgrounds: (1) Participants problematised culture(s) of service users; (2) participants implied cultural superiority in their conceptualisation of 'other' cultures; and (3) participants shared stories of inactions, discomfort and relegating of responsibility. The findings identified these discourses as forms of racial microaggression that can potentially lead to further exclusion of people seeking services and support.
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Affiliation(s)
| | - Lisa Bourke
- Department of Rural Health, The University of Melbourne, Shepparton, Australia
| | - Olivia Mitchell
- Department of Rural Health, The University of Melbourne, Shepparton, Australia
| | - Trudie Newman
- Department of Rural Health, The University of Melbourne, Shepparton, Australia
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Petric S, Hart B, Mohamed J. "Bridging two worlds?": Towards cultural safety within Schools of Nursing in Australian Universities. NURSE EDUCATION TODAY 2022; 110:105176. [PMID: 35121236 DOI: 10.1016/j.nedt.2021.105176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 09/10/2021] [Accepted: 10/13/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Cultural safety has a stronghold within nursing practice and nursing education in Australia and is seen as a philosophy and practice that challenges and refutes previous concepts and frameworks of cultural awareness and cultural competence (Petric, 2019). Cultural safety practices are required for all members of the nursing profession, with a gaze now focused upon Australian Schools of Nursing to demonstrate their commitment and readiness towards cultural safety. AIM This research study measures the commitment and readiness towards cultural safety within Schools of Nursing in Australian universities. METHODS This research study utilises a quantitative descriptive survey design, inviting the Deans of Schools of Nursing in Australia to respond to a modified Occupational Commitment and Health Professional Program Readiness Assessment Compass (DOH, 2014), that measures the current levels of commitment and readiness towards cultural safety. FINDINGS This research study provides evidence of cultural safety strategies within Australian Schools of Nursing with leadership and commitment being the highest scoring factor (M = 34.81; SD 6.34). However, structures towards and support for the implementation of cultural safety strategies and practices were demonstrated as weaknesses (M = 21.18; SD 4.71). DISCUSSION There is a valuable opportunity for leadership and knowledge sharing between Schools of Nursing in Australia. The research outcomes highlight the importance for Schools of Nursing to review, reflect upon, and fully implement the Nursing and Midwifery Curriculum Framework (CATSINaM, 2017) and to audit and report levels of cultural safety. CONCLUSIONS There are cultural safety champions and their leadership is important to the continuing development of curricula, organisations and the profession. These individuals' actions must also be reflected within and supported by organisational cultures, as they fundamentally encourage or obstruct the development of cultural safety in nursing students and academics; material, cultural and human resources are fundamental to the transformations towards cultural safety and to the decolonising practices of the nursing profession (Petric, 2019).
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Affiliation(s)
- Samantha Petric
- School of Nursing, University of Notre Dame Australia, Level 7, 160 Oxford St, Darlinghurst, NSW 2010, Australia
| | - Bethne Hart
- School of Nursing, University of Notre Dame Australia, Level 7, 160 Oxford St, Darlinghurst, NSW 2010, Australia.
| | - Janine Mohamed
- The Lowitja Institute, Suite 1, Level 2, 100 Drummond St, Carlton, Victoria 3053, Australia
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West R, Saunders V, West L, Blackman R, Del Fabbro L, Neville G, Minniss FR, Armao J, van de Mortel T, Kain VJ, Corones-Watkins K, Elder E, Wardrop R, Mansah M, Hilton C, Penny J, Hall K, Sheehy K, Rogers GD. Indigenous-led First Peoples Health Interprofessional and Simulation-Based Learning Innovations: mixed methods study of nursing academics' experience of working in partnership. Contemp Nurse 2022; 58:43-57. [PMID: 35029132 DOI: 10.1080/10376178.2022.2029518] [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] [Indexed: 11/03/2022]
Abstract
BACKGROUND Collaborative, Indigenous-led pedagogical and research approaches in nursing education are fundamental to ensuring culturally safe curriculum innovations that address institutional racism. These approaches privilege, or make central, Indigenous worldviews in the ways healthcare practices are valued and assessed. With the aim of informing excellence in cultural safety teaching and learning, and research approaches, this study draws on the experiences and key learnings of non-Indigenous nursing academics in the collaborative implementation of First Peoples Health interprofessional and simulation-based learning (IPSBL) innovations in an Australian Bachelor of Nursing (BN) program. METHODS An Indigenous-led sequential mixed method design was used to investigate non-Indigenous nursing academics' experiences in the design, development and delivery of two IPSBL innovations. A validated survey (Milne, Creedy & West, 2016) was administered to nursing academics before and after the innovations were delivered. Phenomenological interviews were also conducted following implementation of the innovations. RESULTS Of the 27 staff involved in delivery of the innovations, six nursing academics completed both pre-and post-surveys (22%). Nine (33%) participated in phenomenological interviews. There was a non-significant trend towards improved scores on the awareness of cultural safety scale (ACSS) following the delivery of the innovations. Nursing academics' perceptions of the innovations' relevance to their practice were enhanced. An increased awareness of culturally safe academic practices was reported among those actively involved in innovations. IMPACT STATEMENT Indigenous-led approaches in teaching and research promote excellence within mandatory cultural safety education for nurses and midwives. CONCLUSIONS This study confirms the importance of educating the educators about cultural safety in teaching and learning, and research approaches. It also provides important insights into how non-Indigenous nursing academics can work within Indigenous-led pedagogical and research approaches to design culturally safe curriculum innovations.
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Affiliation(s)
- Roianne West
- School of Nursing Midwifery and First Peoples Health Unit, Griffith University, Level 1, 15 Lancaster Place, Majura Park, ACT, 2609
| | - Vicki Saunders
- PhD Senior Research Fellow, CATSINAM and First Peoples Health Unit, Griffith University, Level 1, 15 Lancaster Place, Majura Park, ACT, 2609
| | - Leeona West
- Senior Project Manager, CATSINAM and School of Nursing and Midwifery, Griffith University, Level 1, 15 Lancaster Place, Majura Park, ACT, 2609
| | - Renee Blackman
- CEO Gidgee Healing Aboriginal Medical Service, School of Nursing and Midwifery, Griffith University, 121 Marian Street, Mt Isa, QLD, 4825
| | - Letitia Del Fabbro
- Lecturer, School of Nursing and Midwifery and Griffith University, Nursing and Midwifery Education and Research Unit, Gold Coast Hospital and Health Service, 1 Parklands Drive, Southport, QLD 4215, Australia
| | - Georgina Neville
- School of Nursing and Midwifery, Griffith University, 68 University Drive, Meadowbrook, QLD 4111
| | - Fiona Rowe Minniss
- Senior Project Manager, CATSINAM and First Peoples Health Unit, Griffith University, Level 1, 15 Lancaster Place, Majura Park, ACT, 2609
| | - Jessica Armao
- Senior Research Assistant, CATSINAM and First Peoples Health Unit, Griffith University, Level 1, 15 Lancaster Place, Majura Park, ACT, 2609
| | - Thea van de Mortel
- Deputy Head of School (Learning & Teaching), School of Nursing and Midwifery, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia
| | - Victoria J Kain
- Director, Undergraduate Nursing Programs, School of Nursing and Midwifery, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia
| | - Katina Corones-Watkins
- Lecturer, School of Nursing and Midwifery, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia
| | - Elizabeth Elder
- Lecturer, School of Nursing and Midwifery, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia
| | - Rachael Wardrop
- Lecturer, School of Nursing and Midwifery, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia
| | - Martha Mansah
- Lecturer, School of Nursing and Midwifery, Griffith University, Building N48 Nathan Campus, 170 Kessels Rd, Nathan QLD. 4111, Australia
| | - Cieon Hilton
- Research Assistant, First Peoples Health Unit, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia
| | - Jamie Penny
- Research Assistant, First Peoples Health Unit, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia
| | - Kerry Hall
- Lecturer, First Peoples Health Unit, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia
| | - Kylee Sheehy
- Lecturer, First Peoples Health Unit, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia
| | - Gary D Rogers
- Dean of the School of Medicine, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3216, Australia
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18
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West R, Armao JE, Creedy DK, Saunders V, Minnis FR. Measuring effectiveness of cultural safety education in First Peoples health in university and health service settings. Contemp Nurse 2022; 57:356-369. [PMID: 35029134 DOI: 10.1080/10376178.2022.2025876] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Cultural Safety is a mandatory training requirement for the 16 regulated health practitioners in Australia. Tools measuring outcomes need to be appropriate for different education and training contexts. AIM To test refinements to the 25 item Cultural Capability Measurement Tool (CCMT). METHODS Framed by decolonising and relational ways of knowing, being, and doing were privileged in the tool development process. New items of the CCMT were generated through engagement with key knowledge holders. New items were piloted with expert reviewers and modified accordingly to produce a 41-item scale. Two online surveys conducted with 875 students and then 276 health professionals were collected for analysis. Exploratory factor analysis and a parallel analysis were conducted. RESULTS The newly named Ganngaleh nga Yagaleh (GY) tool contained 28 items loaded on 3 factors accounting for 47.95% of variance. Factor 1 (Commitment to Culturally Safe Practice; α = .89) comprised 12 items, Factor 2 (Understanding of History and Power; α = .86) contained 9 items, and Factor 3 (Attitudes, Values, and Beliefs; α = .52) contained 7. Total scale reliability was good (α = .87). IMPACT STATEMENT AND CONCLUSION The GY Scale can be used in education and practice settings. Challenges remain about how educational providers and health services approach cultural safety as a life-long learning journey, and how education and clinical practice embed cultural safety standards. Future directions for use of the GY tool include expanding it for use in other contexts and more explicit separation of what is emerging as a separate scale the 'Keeping Culture Strong' scale which evaluates the unique learning experiences of First Peoples.
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Affiliation(s)
- Roianne West
- Kalkadoon, Djkunde Griffith University, School of Nursing and Midwifery, Gold Coast Campus, Brisbane, Australia
| | - Jessica E Armao
- Griffith University, School of Nursing and Midwifery, Gold Coast Campus, Brisbane, Australia
| | - Debra K Creedy
- School of Nursing and Midwifery, Griffith University Griffith University, School of Nursing and Midwifery, Logan Campus, Brisbane, Australia
| | | | - Fiona Rowe Minnis
- Congress of Aboriginal and Torres Stcrrait Islander Nurses and Midwives (CATSINaM) Level 1, 15 Lancaster Place, Majura Park, Canberra, ACT, 2609
- PO Box 656 Fyshwick ACT 2609, Australia
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McGough S, Wynaden D, Gower S, Duggan R, Wilson R. There is no health without cultural safety: Why cultural safety matters. Contemp Nurse 2022; 58:33-42. [PMID: 35014602 DOI: 10.1080/10376178.2022.2027254] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The authors would like to pay respect to Aboriginal and Torres Strait Islander Peoples by acknowledging the traditional owners of the lands on which this paper was written, the Wadjuk people of the Nyungar Nation and the Darkinjung people. One author (XX) would like to acknowledge her Wiradjuri ancestry and express respect to her Elders past and present and to Culture and Country.
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Affiliation(s)
- S McGough
- School of Nursing. Curtin University, Perth, Australia
| | - D Wynaden
- School of Nursing. Curtin University, Perth, Australia
| | - S Gower
- School of Nursing. Curtin University, Perth, Australia
| | - R Duggan
- School of Nursing. Curtin University, Perth, Australia
| | - R Wilson
- School of Nursing. Curtin University, Perth, Australia.,School of Nursing and Midwifery. The University of Newcastle, Australia.,School of Nursing. Massey University, New Zealand
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McCalman J, Jongen CS, Campbell S, Fagan R, Pearson K, Andrews S. The Barriers and Enablers of Primary Healthcare Service Transition From Government to Community Control in Yarrabah: A Grounded Theory Study. Front Public Health 2021; 9:616742. [PMID: 34722428 PMCID: PMC8551548 DOI: 10.3389/fpubh.2021.616742] [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: 10/13/2020] [Accepted: 09/10/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Consistent with the aspirations of First Nations Australians for community control of healthcare services, 123/196 (63%) of Australia's First Nations-specific primary health care services are community-controlled. Yet despite policy commitment over 30 years, the transition of government-run First Nations' primary healthcare services to First Nations community control has been slow. This paper identifies the barriers and enablers to transitioning the delivery of primary healthcare services from Queensland Health to Gurriny Yealamucka community-controlled health service in Yarrabah. Methods: Grounded theory methods were used to select 14 Gurriny and Queensland Health (QH) personnel involved in the transition for interview and to analyse these interview transcripts and 88 Gurriny organisational documents. Results: Barriers and enablers to transition were identified at three levels: those internal factors within Gurriny, external factors directly related to the government handover, and broader structural and policy factors outside the control of either Gurriny or QH. Barriers at the Gurriny organisational level were an internal lack of experience and capacity, and varying levels of community confidence; enablers were leadership stability and capacity, community mandate, relationships with partner organisations, and ability to provide service continuity. Barriers in Gurriny's relationship with QH were a lack of certainty, transparency and prioritisation of the transition process; systemic racism; difficulties obtaining and maintaining the necessary workforce; limited resources including insufficient, unstable and inappropriate funding support; and problems with information sharing; enablers were performance frameworks to keep transition progress on track. Barriers in broad policy environment were an unsupportive Queensland government policy environment; government bureaucracy; and delays, conflicts and divisions; enablers were high-level government support and commitment. Conclusions: The evaluation of Yarrabah's transition process suggests that future such transitions will require planning and commitment to a long-term, multi-faceted and complex process, encompassing the required level of authorisation and resourcing. This case example of a transition from government to community control of PHC highlighted the ongoing power issues that are faced every day by community-controlled organisations that co-exist with mainstream health systems within a colonial power structure.
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Affiliation(s)
- Janya McCalman
- Centre for Indigenous Health Equity Research, Central Queensland University, Cairns, QLD, Australia
| | - Crystal Sky Jongen
- Centre for Indigenous Health Equity Research, Central Queensland University, Cairns, QLD, Australia
| | - Sandy Campbell
- Centre for Indigenous Health Equity Research, Central Queensland University, Cairns, QLD, Australia.,Molly Wardaguga Research Centre, Charles Darwin University, Darwin, NT, Australia
| | - Ruth Fagan
- Gurriny Yealamucka Health Service, Yarrabah, QLD, Australia
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McLeod K, Fullagar S. Remaking the post 'human': a productive problem for health sociology. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2021; 30:219-228. [PMID: 34720046 DOI: 10.1080/14461242.2021.1990710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Kim McLeod
- School of Social Sciences, University of Tasmania, Launceston, Australia
| | - Simone Fullagar
- Centre for Social and Cultural Research, Griffith University, Nathan, Australia
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Eni R, Phillips-Beck W, Achan GK, Lavoie JG, Kinew KA, Katz A. Decolonizing health in Canada: A Manitoba first nation perspective. Int J Equity Health 2021; 20:206. [PMID: 34526038 PMCID: PMC8442310 DOI: 10.1186/s12939-021-01539-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 08/24/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION & BACKGROUND Global persistence of health inequities for Indigenous peoples is evident in ongoing discrepancies in health and standards of living. International literature suggests the key to transformation lies in Indigenous efforts to control Indigenous health and healthcare. Previous authors have focused upon participation, structural transformation, and culturally appropriate healthcare recognized as a political right as fundamental tenets of Indigenous control. Contextualizing Indigenous health and wellness falls within a growing discussion on decolonization - a resituating of expertise that privileges Indigenous voice and interests. METHODS The study is a qualitative, grounded theory analysis, which is a constructivist approach to social research allowing for generation of theory in praxis, through interactions and conversations between researchers and participants. One hundred eighty-three interviews with additional focus groups were held between 2013-15 in eight Manitoba First Nation communities representing different models of health delivery, geographies, accessibilities, and Indigenous language groups. Community research assistants and respected Elders participated in data collection, analysis and interpretation. Line-by-line coding and constant comparative method led to the discovery of converging themes. FINDINGS Ultimately four main themes arose: 1) First Nation control of healthcare; 2) traditional medicine and healing activities; 3) full and meaningful community participation; and 4) cleaning up impacts of colonization. Joint analyses and interpretation of findings revealed substantial evidence that communities were looking profoundly into problems of improperly delivered services and health inequities. Issues were consistent with those highlighted by international commissions on reconciliation, health, Indigenous rights and liberties. To those documents, these findings add ground upon which to build the transformative agenda. RESULTS & DISCUSSION Communities discussed the need for creation of protocols, constitution and laws to ensure growth of a decolonizing agenda. Inclusive to the concept are holistic, preventative, traditional health perspectives, and Indigenous languages. Colonization impacts were of critical concern and in need of undoing. Sharing of social and political efforts is seen as pivotal to change and includes all members of communities.
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Affiliation(s)
- Rachel Eni
- Community Health Sciences, College of Medicine, University of Manitoba, Independent Researcher, Victoria, BC, V9C 0M1, Canada.
| | - Wanda Phillips-Beck
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, First Nation Health and Social Secretariat Manitoba and the University of Manitoba, Winnipeg, MB, R3B 2B3, Canada
| | - Grace Kyoon Achan
- Education Indigenous Institute of Health and Healing, University of Manitoba, Winnipeg, MB, R3E 3P4, Canada
| | - Josée G Lavoie
- Department Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 3P5, Canada
| | - Kathi Avery Kinew
- First Nation Health and Social Secretariat Manitoba, Winnipeg, MB, R3B 2B3, Canada
| | - Alan Katz
- Department of Family Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3B 2B3, Canada
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Swidrovich J. A Canadian perspective of pharmacy education for students belonging to diverse groups. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:895-902. [PMID: 34074524 DOI: 10.1016/j.cptl.2021.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/14/2020] [Accepted: 03/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Attention to equity, diversity, and inclusion (EDI) is on the rise in Canada, the United States, and the world. While there are evolving efforts across various sectors, post-secondary institutions, in particular, are growing in EDI efforts. For health professional programs, including pharmacy, health disparities are addressed and improvements in health care are realized when faculty are committed to EDI in hiring, admissions, and teaching and learning. To inform the direction and highlight the importance of further EDI research, programming, and evaluation, this paper analyzes the existing literature in pharmacy education and the education of diverse groups. METHODS Several databases were searched, resulting in 17 articles of varying scopes (e.g., reviews, commentaries, reports) that capture principles of pharmacy education for diverse or marginalized students. While other articles were screened for inclusion, the concepts of culture, equity, diversity, and inclusion were presented as part of classroom and curricular topics (e.g., learning about the topics) and did not contain mention or evaluation of the education of diverse or marginalized students in pharmacy. RESULTS Pharmacy education literature for diverse and/or marginalized student groups is limited. While significant publications exist regarding pharmacy education about EDI, little attention has been given to how pharmacy programs and educators may adapt their teaching and learning practices, policies, procedures, and admission processes to move beyond the status quo. IMPLICATIONS Findings from this review will better inform pharmacy education programs to engage in the research and practice of conscious continuous improvement of safe spaces for diverse pharmacy students.
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Affiliation(s)
- Jaris Swidrovich
- University of Saskatchewan College of Pharmacy and Nutrition, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada.
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Wright M, Brown A, Dudgeon P, McPhee R, Coffin J, Pearson G, Lin A, Newnham E, King Baguley K, Webb M, Sibosado A, Crisp N, Flavell HL. Our journey, our story: a study protocol for the evaluation of a co-design framework to improve services for Aboriginal youth mental health and well-being. BMJ Open 2021; 11:e042981. [PMID: 34011581 PMCID: PMC8137218 DOI: 10.1136/bmjopen-2020-042981] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 03/10/2021] [Accepted: 04/14/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Mainstream Australian mental health services are failing Aboriginal young people. Despite investing resources, improvements in well-being have not materialised. Culturally and age appropriate ways of working are needed to improve service access and responsiveness. This Aboriginal-led study brings Aboriginal Elders, young people and youth mental health service staff together to build relationships to co-design service models and evaluation tools. Currently, three Western Australian youth mental health services in the Perth metropolitan area and two regional services are working with local Elders and young people to improve their capacity for culturally and age appropriate services. Further Western Australian sites will be engaged as part of research translation. METHODS AND ANALYSIS Relationships ground the study, which utilises Indigenous methodologies and participatory action research. This involves Elders, young people and service staff as co-researchers and the application of a decolonising, strengths-based framework to create the conditions for engagement. It foregrounds experiential learning and Aboriginal ways of working to establish relationships and deepen non-Aboriginal co-researchers' knowledge and understanding of local, place-based cultural practices. Once relationships are developed, co-design workshops occur at each site directed by local Elders and young people. Co-designed evaluation tools will assess any changes to community perceptions of youth mental health services and the enablers and barriers to service engagement. ETHICS AND DISSEMINATION The study has approval from the Kimberley Aboriginal Health Planning Forum Kimberley Research Subcommittee, the Western Australian Aboriginal Health Ethics Committee, and the Curtin University Human Research Ethics Committee. Transferability of the outcomes across the youth mental health sector will be directed by the co-researchers and is supported through Aboriginal and non-Aboriginal organisations including youth mental health services, peak mental health bodies and consumer groups. Community reports and events, peer-reviewed journal articles, conference presentations and social and mainstream media will aid dissemination.
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Affiliation(s)
- Michael Wright
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Alex Brown
- Indigenous Health, SAHMRI, Adelaide, South Australia, Australia
| | - Patricia Dudgeon
- School of Indigenous Studies, The University of Western Australia, Perth, Western Australia, Australia
| | - Rob McPhee
- Kimberley Aboriginal Medical Service, Broome, Western Australia, Australia
| | - Juli Coffin
- Telethon Kids Institute, Broome, Western Australia, Australia
| | - Glenn Pearson
- Aboriginal Health Institute Leadership Team, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Ashleigh Lin
- Telethon Institute for Child Health Research, Nedlands, Western Australia, Australia
| | - Elizabeth Newnham
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | | | - Michelle Webb
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Amanda Sibosado
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Nikayla Crisp
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
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Gerrard JM, Godwin S, Chuter V, Munteanu SE, West M, Hawke F. Release of the National Scheme's Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025; the impacts for podiatry in Australia: a commentary. J Foot Ankle Res 2021; 14:38. [PMID: 33971934 PMCID: PMC8108329 DOI: 10.1186/s13047-021-00466-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/16/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Developing since colonisation, Australia's healthcare system has dismissed an ongoing and successful First Nations health paradigm in place for 60,000 years. From Captain James Cook documenting 'very old' First Nations Peoples being 'far more happier than we Europeans' and Governor Arthur Phillip naming Manly in admiration of the physical health of Gadigal men of the Eora Nation, to anthropologist Daisy Bates' observation of First Nations Peoples living 'into their eighties' and having a higher life expectancy than Europeans; our healthcare system's shameful cultural safety deficit has allowed for an Aboriginal and Torres Strait Islander child born in Australia today to expect to live 9 years less than a non-Indigenous child. Disproportionately negative healthcare outcomes including early onset diabetes-related foot disease and high rates of lower limb amputation in Aboriginal and Torres Strait Islander Peoples contribute to this gross inequity. MAIN BODY In 2020, the Australian Health Practitioner Regulation Authority released the National Scheme's Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025 - empowering all registered health practitioners within Australia to provide health care to Aboriginal and Torres Strait Islander Peoples that is inclusive, respectful and safe, as judged by the recipient of care. This recently released strategy is critically important to the podiatry profession in Australia. As clinicians, researchers and educators we have a collective responsibility to engage with this strategy of cultural safety. This commentary defines cultural safety for podiatry and outlines the components of the strategy in the context of our profession. Discussion considers the impact of the strategy on podiatry. It identifies mechanisms for podiatrists in all settings to facilitate safer practice, thereby advancing healthcare to produce more equitable outcomes. CONCLUSION Aboriginal and Torres Strait Islander Peoples access health services more frequently and have better health outcomes where provision of care is culturally safe. By engaging with the National Scheme's Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy, all registered podiatrists in Australia can contribute to achieving equity in health outcomes for Aboriginal and Torres Strait Islander Peoples.
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Affiliation(s)
- James M Gerrard
- College of Health, Medicine and Wellbeing, School of Health Sciences, University of Newcastle, Ourimbah, NSW, 2258, Australia. .,Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086, Australia.
| | - Shirley Godwin
- Rural Department of Nursing & Midwifery, La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, 3552, Australia
| | - Vivienne Chuter
- College of Health, Medicine and Wellbeing, School of Health Sciences, University of Newcastle, Ourimbah, NSW, 2258, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Ourimbah, NSW, 2258, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086, Australia
| | - Matthew West
- College of Health, Medicine and Wellbeing, School of Health Sciences, University of Newcastle, Ourimbah, NSW, 2258, Australia
| | - Fiona Hawke
- College of Health, Medicine and Wellbeing, School of Health Sciences, University of Newcastle, Ourimbah, NSW, 2258, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Ourimbah, NSW, 2258, Australia
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26
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Ryder C, Mackean T, Hunter K, Coombes J, Holland AJA, Ivers R. Yarning up about out-of-pocket healthcare expenditure in burns with Aboriginal families. Aust N Z J Public Health 2021; 45:138-142. [PMID: 33683766 DOI: 10.1111/1753-6405.13083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/01/2020] [Accepted: 01/01/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE This study sought to understand the impact of out-of-pocket healthcare expenditure (OOPHE) on Aboriginal families of children with acute burns injury. METHODS Families participating in a larger Australia-wide study on burns injuries in Aboriginal and Torres Strait Islander children were approached to participate. Decolonising methodology and yarning were employed with participants to scope OOPHE for burns care. Thematic analyses were used with transcripts and data organised using qualitative analysis software (NVivo, Version 12). RESULTS Six families agreed to participate. Four yarning sessions were undertaken across South Australia, New South Wales and Queensland. The range of OOPHE identified included: costs (transport, pain medication, bandages), loss (employment capacity, social and community) and support (family, service support). The need to cover OOPHE significantly impacted on participants, from restricting social interactions to paying household bills. Close family connections and networks were protective in alleviating financial burden. CONCLUSION OOPHE for burns care financially impacted Aboriginal families. Economic hardship was reported in families residing rurally or with reduced employment capacity. Family and network connections were mitigating factors for financial burden. Implications for public health: Targeted support strategies are required to address OOPHE in burns-related injuries for Aboriginal communities.
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Affiliation(s)
- Courtney Ryder
- The George Institute for Global Health Australia, UNSW, New South Wales.,Aboriginal and Torres Strait Islander Public Health, Discipline of Public Health, College of Medicine Public Health, Flinders University, South Australia
| | - Tamara Mackean
- The George Institute for Global Health Australia, UNSW, New South Wales.,Aboriginal and Torres Strait Islander Public Health, Discipline of Public Health, College of Medicine Public Health, Flinders University, South Australia
| | - Kate Hunter
- The George Institute for Global Health Australia, UNSW, New South Wales
| | - Julieann Coombes
- The George Institute for Global Health Australia, UNSW, New South Wales.,Jumbunna, The University of Technology Sydney, New South Wales
| | - Andrew J A Holland
- The University of Sydney School of Medicine, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, New South Wales
| | - Rebecca Ivers
- The George Institute for Global Health Australia, UNSW, New South Wales.,School of Public Health and Community Medicine, UNSW, New South Wales
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Dale E, Lee KSK, Conigrave KM, Conigrave JH, Ivers R, Clapham K, Kelly PJ. A multi-methods yarn about SMART Recovery: First insights from Australian Aboriginal facilitators and group members. Drug Alcohol Rev 2021; 40:1013-1027. [PMID: 33686719 PMCID: PMC8451896 DOI: 10.1111/dar.13264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION SMART Recovery is a popular mutual support group program. Little is known about its suitability or perceived helpfulness for Indigenous peoples. This study explored the cultural utility of SMART Recovery in an Australian Aboriginal context. METHODS An Indigenous-lensed, multi-methods, exploratory study design was used to develop initial evidence of: (i) attributes of Aboriginal SMART Recovery facilitators and group members; (ii) characteristics of Aboriginal-led SMART Recovery groups; (iii) perceived acceptability and helpfulness of SMART Recovery; and (iv) areas for potential improvement. Data were collected by synthesising Indigenous qualitative methods (research topic and social yarning) with western qualitative and quantitative methods (participant surveys, program adherence rating scale, group observations and field notes). Data were analysed using thematic analysis. RESULTS Participants were a culturally diverse sample of male and female Aboriginal facilitators (n = 10) and group members (n = 11), aged 22-65 years. Aboriginal-led SMART Recovery groups were culturally customised to suit local contexts. Program tools 'goal setting' and 'problem solving' were viewed as the most helpful. Suggested ways SMART Recovery could enhance its cultural utility included: integration of Aboriginal perspectives into facilitator training; creation of Aboriginal-specific program and marketing materials; and greater community engagement and networking. Participants proposed an Aboriginal-specific SMART Recovery program. DISCUSSION AND CONCLUSIONS This study offers insights into Aboriginal peoples' experiences of SMART Recovery. Culturally-informed modifications to the program were identified that could enhance cultural utility. Future research is needed to obtain diverse community perspectives and measure health outcomes associated with group attendance.
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Affiliation(s)
- Elizabeth Dale
- Illawarra Health and Medical Research Institute, School of Psychology, University of Wollongong, Wollongong, Australia
| | - K S Kylie Lee
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia.,La Trobe University, Centre for Alcohol Policy Research, Melbourne, Australia
| | - Katherine M Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Drug Health Services, Sydney, Australia
| | - James H Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia
| | - Rowena Ivers
- Australia School of Medicine, The University of Wollongong, Wollongong, Australia.,Illawarra Aboriginal Medical Service, Wollongong, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, Faculty of Business, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute, School of Psychology, University of Wollongong, Wollongong, Australia.,School of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
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28
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Ireland S, Maypilama EL. "We are sacred": An intercultural and multilingual approach to understanding reproductive health literacy for Yolŋu girls and women in remote Northern Australia. Health Promot J Austr 2021; 32 Suppl 1:192-202. [PMID: 33159372 DOI: 10.1002/hpja.439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/10/2022] Open
Abstract
ISSUE ADDRESSED Indigenous women continue to experience reproductive health inequities. While enhancing health literacy is suggested as an approach for reducing disparities and increasing equity, there is a paucity of literature exploring Indigenous women's conceptualisation of reproductive health literacy. This paper demonstrates one approach to developing a reproductive health literacy framework for Yolŋu (Indigenous) women in a remote Northern Australian setting. METHODS Using a decolonising participatory action research approach, a senior Yolŋu researcher led interviews, group story sharing sessions, historic site visits and on-country cultural demonstration sessions with participants on reproductive health topics. Data were collected in the participants' first language(s) and occasionally in English. Data were digitally recorded on camera, Dictaphone, video and in handwritten notes. The senior Yolŋu researcher worked with a Yolŋu interpreter to translate the data into English. Data underwent a progressive verbal relational content analysis to map and build a framework. RESULTS A reproductive health literacy framework that privileges Yolŋu reproductive knowledge, practices and language was successfully co-designed. The framework was embedded in the metaphor of Pandanus mat and uses key cultural domains of Yolŋu identity as a connecting foundation to women's reproductive knowledges and ceremonial milestones. CONCLUSIONS The framework offers a culturally responsive and multilingual approach to sensitively discuss and operationalise reproductive health literacy. The framework empowers Yolŋu cultural identities; accounts for both Yolŋu and Western medical knowledges; and honours participants' requests for "Two-Way" learning. SO WHAT?: This research demonstrates an innovative approach to co-designing a culturally responsive framework for reproductive health literacy in a complex and multilingual context. Such approaches offer a promising way forward for empowering Indigenous women to define reproductive health literacy and contribute to improving their reproductive health outcomes.
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Affiliation(s)
- Sarah Ireland
- Molly Wardaguga Research Centre, Charles Darwin University, Casuarina, NT, Australia
| | - Elaine L Maypilama
- The Northern Institute, Charles Darwin University, Casuarina, NT, Australia
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Mackean T, Fisher M, Friel S, Baum F. A framework to assess cultural safety in Australian public policy. Health Promot Int 2020; 35:340-351. [PMID: 30796455 DOI: 10.1093/heapro/daz011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The concept of cultural safety (CS) has been developed as a critical perspective on healthcare provided to Indigenous service users in neo-colonial countries such as New Zealand, Australia and Canada. Unlike other frameworks for culturally competent healthcare, a CS approach recognizes impacts of colonization and power inequalities on Indigenous peoples and asks how these may manifest in healthcare settings. It has been argued that CS thinking is suited to critical analysis of public policy, but there has been limited work in this direction. Drawing on literature on CS in Australian healthcare, we defined a CS framework consisting of five concepts: reflexivity, dialogue, reducing power differences, decolonization and regardful care. Our research examined whether and in what terms this framework could be adapted as a tool for critical analysis of Australian public policy as it affects Aboriginal and Torres Strait Islander peoples. We used a collaborative inquiry process combining perspectives of an Aboriginal researcher and a non-Indigenous researcher. We developed a thematic analysis framework to examine how the five concepts might be reflected in contemporary writings on policy by leading Aboriginal or Torres Strait Islander thinkers. We found the framework is applicable as a tool for policy analysis; bringing together key concerns raised by Aboriginal and Torres Strait Islander leaders and critical concepts such as sovereignty and interface thinking. We concluded the framework is likely to be a useful tool for critical, systemic thinking about public policy as it affects Indigenous peoples and for specifying areas where performance can be improved to achieve culturally safe policy.
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Affiliation(s)
- Tamara Mackean
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia.,The George Institute for Global Health, Level 5/1 King St, Newtown 2042, New South Wales, Australia.,NHMRC Centre for Research Excellence in the Social Determinants of Health Equity, Southgate Institute, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia
| | - Matthew Fisher
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia.,NHMRC Centre for Research Excellence in the Social Determinants of Health Equity, Southgate Institute, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia
| | - Sharon Friel
- NHMRC Centre for Research Excellence in the Social Determinants of Health Equity, Southgate Institute, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia.,RegNet School of Regulation and Global Governance, Coombs Extension Building 8, The Australian National University, Canberra 2601, Australian Capital Territory, Australia.,Menzies Centre for Health Policy, Coombs Extension Building 8, The Australian National University, Canberra 2601, Australian Capital Territory, Australia
| | - Frances Baum
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia.,NHMRC Centre for Research Excellence in the Social Determinants of Health Equity, Southgate Institute, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia
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30
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Older Aboriginal Australians' Health Concerns and Preferences for Healthy Ageing Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207390. [PMID: 33050541 PMCID: PMC7600369 DOI: 10.3390/ijerph17207390] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 12/18/2022]
Abstract
While there is strong evidence of the need for healthy ageing programs for older Aboriginal Australians, few are available. It is important to understand older Aboriginal Australians’ perspectives on healthy ageing in order to co-design culturally-appropriate programs, including views on technology use in this context. Semi-structured interviews were conducted with 34 Aboriginal Australians aged 50 years and older from regional and urban communities to explore participants’ health concerns, preferences for healthy ageing programs, and receptiveness to technology. Qualitative data were analyzed using a grounded theory approach. This study found that older Aboriginal Australians are concerned about chronic health conditions, social and emotional well-being, and difficulties accessing health services. A range of barriers and enablers to participation in current health programs were identified. From the perspective of older Aboriginal people, a successful healthy ageing program model includes physical and cognitive activities, social interaction, and health education. The program model also provides culturally safe care and transport for access as well as family, community, cultural identity, and empowerment regarding ageing well as central tenets. Technology could also be a viable approach for program delivery. These findings can be applied in the implementation and evaluation of culturally-appropriate, healthy ageing programs with older Aboriginal people.
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Trauma and Violence Informed Care Through Decolonising Interagency Partnerships: A Complexity Case Study of Waminda's Model of Systemic Decolonisation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207363. [PMID: 33050193 PMCID: PMC7601198 DOI: 10.3390/ijerph17207363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 12/21/2022]
Abstract
Through the lens of complexity, we present a nested case study describing a decolonisation approach developed and implemented by Waminda South Coast Women’s Health and Welfare Aboriginal Corporation. Using Indigenous research methods, this case study has unfolded across three phases: (1) Yarning interviews with the workforce from four partner health services (n = 24); (2) Yarning circle bringing together key informants from yarning interviews to verify and refine emerging themes (n = 14); (3) Semi-structured interviews with a facilitator of Waminda’s Decolonisation Workshop (n = 1) and participants (n = 10). Synthesis of data has been undertaken in stages through collaborative framework and thematic analysis. Three overarching themes and eight sub-themes emerged that centred on enhancing the capabilities of the workforce and strengthening interagency partnerships through a more meaningful connection and shared decolonisation agenda that centres Aboriginal and Torres Strait Islander families and communities. Health and social services are complex systems that function within the context of colonisation. Waminda’s innovative, model of interagency collaboration enhanced workforce capability through shared language and collective learning around colonisation, racism and Whiteness. This process generated individual, organisational and systemic decolonisation to disable power structures through trauma and violence informed approach to practice.
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Ryder C, Mackean T, Hunter K, Towers K, Rogers K, Holland AJA, Ivers R. Factors contributing to longer length of stay in Aboriginal and Torres Strait Islander children hospitalised for burn injury. Inj Epidemiol 2020; 7:52. [PMID: 33012291 PMCID: PMC7534159 DOI: 10.1186/s40621-020-00278-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander children have higher incidence, severity and hospital length of stay for their acute burn injuries than other Australian children. We examined factors contributing to longer length of stay for Aboriginal and Torres Strait Islander children with an acute burn injury. METHODS Burns Registry of Australia and New Zealand admissions of children < 16 years of age between October 2009 and July 2018 were analysed. Descriptive statistics explored patient and injury characteristics; Cox-regression models estimated characteristics associated with longer length of stay. Knowledge Interface methodology and Indigenous research methods were used throughout. RESULTS A total of 723 children were identified as Aboriginal and Torres Strait Islander and 6257 as other Australian. The median hospital length of stay for Aboriginal and Torres Strait Islander children (5 days [CI 5-6]) was 4 days longer than other Australian children (1 day [CI 1-2]). Remoteness, flame burns, high percentage total body surface area (%TBSA) and full thickness burns were factors associated with longer length of stay for Aboriginal and Torres Strait Islander children. Similar prognostic factors were identified for other Australian children along with Streptococcus sp. and Staphylococcus sp. infection. CONCLUSION Remoteness, flame burns, %TBSA, and full thickness burns are prognostic factors contributing to extended hospital length of stay for all Australian children. These factors are more prevalent in Aboriginal and Torres Strait Islander children, impacting length of stay. Treatment programs, clinical guidelines, and burns policies should engage with the unique circumstances of Aboriginal and Torres Strait Islander children to mitigate inequities in health.
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Affiliation(s)
- Courtney Ryder
- The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Rd, Sydney, NSW, 2050, Australia. .,Aboriginal and Torres Strait Islander Health, College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
| | - Tamara Mackean
- The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Rd, Sydney, NSW, 2050, Australia.,Aboriginal and Torres Strait Islander Health, College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Kate Hunter
- The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Rd, Sydney, NSW, 2050, Australia
| | - Kurt Towers
- Watto Paruna Aboriginal Health for the Northern Adelaide Local Health Network, Corner of Mark and Oldham Roads, Elizabeth Vale, SA, 5112, Australia
| | - Kris Rogers
- The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Rd, Sydney, NSW, 2050, Australia.,Graduate School of Health, University of Technology Sydney, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Andrew J A Holland
- Sydney Medical School, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia
| | - Rebecca Ivers
- The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Rd, Sydney, NSW, 2050, Australia.,School of Public Health and Community Medicine, UNSW, Sydney, 2052, Australia
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Ryder C, Mackean T, Hunter K, Rogers K, Holland AJA, Ivers R. Burn Injuries in Hospitalized Australian Children-An Epidemiological Profile. J Burn Care Res 2020; 42:381-389. [PMID: 32910200 DOI: 10.1093/jbcr/iraa159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Globally, First Nations children sustain burns at a higher rate than other children. Little is understood about how health inequities contribute, especially from an Indigenous viewpoint. We analyzed data from the Burns Registry of Australian and New Zealand (BRANZ) for acute burns in children (<16 years) admitted to hospital between October 2009 and July 2018. Descriptive statistics examined equity variables in patient and injury characteristics. Poisson regression was used to describe factors associated with bacterial infection. Indigenous research methods were used throughout. Aboriginal and Torres Strait Islander children represented 10.4% of the study population. Health inequities were present for Aboriginal and Torres Strait Islander children with longer hospital length of stay (9.5 vs 4.6 days), rural residency (61.3% vs 13.9%), lower socioeconomic status (72.2% vs 34.9%), and more flame burns (19.5% vs 10.6%) compared to other Australian children. Streptococcus sp. infection risk was four times greater in Aboriginal and Torres Strait Islander children compared to other Australian children. Flame burns and high percentage total body surface area burns were a risk for Staphylococcus sp. and Streptococcus sp. infection in all children. The epidemiological profile for burn injuries managed in Australian burns centers differs between Aboriginal and Torres Strait Islander children and other children, indicating persistent health inequities. These differences should be considered in the development of injury prevention strategies and the clinical management of burn injuries for Aboriginal and Torres Strait Islander children and their families.
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Affiliation(s)
- Courtney Ryder
- Injury Division, The George Institute for Global Health Australia, University of New South Wales, Australia.,Aboriginal and Torres Strait Islander Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Tamara Mackean
- Injury Division, The George Institute for Global Health Australia, University of New South Wales, Australia.,Aboriginal and Torres Strait Islander Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Kate Hunter
- Injury Division, The George Institute for Global Health Australia, University of New South Wales, Australia
| | - Kris Rogers
- Injury Division, The George Institute for Global Health Australia, University of New South Wales, Australia.,Graduate School of Health, University of Technology Sydney, New South Wales, Australia
| | - Andrew J A Holland
- The University of Sydney School of Medicine, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, New South Wales, Australia
| | - Rebecca Ivers
- Injury Division, The George Institute for Global Health Australia, University of New South Wales, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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Min J, Albon S, Leung L, Clarke A. Creating a pharmacy elective course in Indigenous health. CURRENTS IN PHARMACY TEACHING & LEARNING 2020; 12:1004-1013. [PMID: 32564987 DOI: 10.1016/j.cptl.2020.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 02/11/2020] [Accepted: 04/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND PURPOSE There is a critical need for greater Indigenous health education and cultural safety training for pharmacists. The objective of this paper is to describe the creation, development, and impact of Canada's first offering of an undergraduate elective course specific to pharmaceutical care in Indigenous health. EDUCATIONAL ACTIVITY AND SETTING A three-credit elective course was developed and offered to bachelor of science pharmacy students at the University of British Columbia. A variety of pedagogical approaches including reflection, educational trips, video conferencing with Indigenous communities, and Indigenous community-based projects were used. Evaluation of student learning impact included quantitative and qualitative post-course survey data, student enrollment, and student work. FINDINGS From course inception in 2012 to 2017, 101 students participated. Survey respondents rated an average of 4.7 out of 5 on the five core elements of the curriculum design and pedagogical practice (i.e. learning objectives, instructional methods, assessments, organization, and workload). Thematic analysis identified three themes: 1) the qualities of the course instructors, 2) the unique curriculum design and pedagogical practices, and 3) significant personal and professional impact on students. SUMMARY This course is one of few opportunities for pharmacy students to learn about cultural safety as it relates to the pharmaceutical care of Indigenous peoples. Extensive engagement with stakeholders and utilization of various teaching and assessment techniques were beyond the expected requirements of course offerings. Students highly rated this course as having personal and professional impact. This course plays a critical role in the overall Indigenization of pharmacy curricula.
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Affiliation(s)
- Jason Min
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
| | - Simon Albon
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
| | - Larry Leung
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
| | - Allison Clarke
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
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Wilson A, Wilson R, Delbridge R, Tonkin E, Palermo C, Coveney J, Hayes C, Mackean T. Resetting the Narrative in Australian Aboriginal and Torres Strait Islander Nutrition Research. Curr Dev Nutr 2020; 4:nzaa080. [PMID: 32467866 PMCID: PMC7241202 DOI: 10.1093/cdn/nzaa080] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 04/14/2020] [Accepted: 04/30/2020] [Indexed: 11/14/2022] Open
Abstract
As the oldest continuous living civilizations in the world, Aboriginal and Torres Strait Islander peoples have strength, tenacity, and resilience. Initial colonization of the landscape included violent dispossession and removal of people from Country to expand European land tenure and production systems, loss of knowledge holders through frontier violence, and formal government policies of segregation and assimilation designed to destroy ontological relationships with Country and kin. The ongoing manifestations of colonialism continue to affect food systems and food knowledges of Aboriginal peoples, and have led to severe health inequities and disproportionate rates of nutrition-related health conditions. There is an urgent need to collaborate with Aboriginal and Torres Strait Islander peoples to address nutrition and its underlying determinants in a way that integrates Aboriginal and Torres Strait Islander peoples' understandings of food and food systems, health, healing, and well-being. We use the existing literature to discuss current ways that Australian Aboriginal and Torres Strait Islander peoples are portrayed in the literature in relation to nutrition, identify knowledge gaps that require further research, and propose a new way forward.
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Affiliation(s)
- Annabelle Wilson
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Roland Wilson
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Robyn Delbridge
- Department of Health Professions, Swinburne University, Melbourne, Victoria, Australia
| | - Emma Tonkin
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| | - John Coveney
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Colleen Hayes
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Tamara Mackean
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Pratt B, Wild V, Barasa E, Kamuya D, Gilson L, Hendl T, Molyneux S. Justice: a key consideration in health policy and systems research ethics. BMJ Glob Health 2020. [PMCID: PMC7245410 DOI: 10.1136/bmjgh-2019-001942] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Health policy and systems research (HPSR) is increasingly being funded and conducted worldwide. There are currently no specific guidelines or criteria for the ethical review and conduct of HPSR. Academic debates on HPSR ethics in the scholarly literature can inform the development of guidelines. Yet there is a deficiency of academic bioethics work relating to justice in HPSR. This gap is especially problematic for a field like HPSR, which can entail studies that intervene in ways affecting the social and health system delivery structures of society. In this paper, we call for interpreting the principle of justice in a more expansive way in developing and reviewing HPSR studies (relative to biomedical research). The principle requires advancing health equity and social justice at population or systems levels. Drawing on the rich justice literature from political philosophy and public health ethics, we propose a set of essential justice considerations to uphold this principle. These considerations are relevant for research funders, researchers, research ethics committees, policymakers, community organisations and others who are active in the HPSR field.
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Affiliation(s)
- Bridget Pratt
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Verina Wild
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Edwine Barasa
- Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Programme, Kilifi, Kenya
| | - Dorcas Kamuya
- Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Programme, Kilifi, Kenya
| | - Lucy Gilson
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Tereza Hendl
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Sassy Molyneux
- Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Oxford University, Oxford, UK
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Swidrovich J. Decolonizing and Indigenizing pharmacy education in Canada. CURRENTS IN PHARMACY TEACHING & LEARNING 2020; 12:237-243. [PMID: 32147167 DOI: 10.1016/j.cptl.2019.11.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 07/14/2019] [Accepted: 11/09/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND An emphasis on equity, diversity, and inclusion is growing within the field of education, including health professions education. In particular, no published literature exists regarding decolonizing and Indigenizing pharmacy education. Post-secondary pharmacy programs in Canada have a unique opportunity to learn from the decolonizing and Indigenizing practices observed in the educational programs of other health professions and post-secondary institutions and become international leaders in this area. METHODS Literature searches on PubMed, MEDLINE, ERIC (Ovid), iPortal, and PsycINFO were performed, revealing zero articles on decolonizing and/or Indigenizing pharmacy education. Search terms were expanded to include all health professions education programs with published literature on decolonizing and Indigenizing practices. All publications that included either or both terms (decolonizing and/or Indigenizing) and within any realm of health professions education (e.g., curriculum, assessment, evaluation, instructional design) were reviewed. RESULTS Literature on decolonizing and Indigenizing health professions education in health disciplines, such as nursing and speech pathology, were reviewed. In conjunction with literature on decolonization and Indigenization of education, with a focus on post-secondary institutions, a number of strategies are proposed to decolonize and Indigenize pharmacy education. IMPLICATIONS Findings from this review will better inform post-secondary pharmacy education programs to engage in decolonization and Indigenization practices. Engaging in decolonization and Indigenization of pharmacy education is expected to not only improve the educational experience of Indigenous students in pharmacy programs, but also improve the care received by Indigenous patients from all graduates of pharmacy.
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Affiliation(s)
- Jaris Swidrovich
- University of Saskatchewan, College of Pharmacy and Nutrition, 104 Clinic Place, Saskatoon S7N 2Z4, Saskatchewan, Canada.
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Schultz R. Closing the Gap and the Sustainable Development Goals: listening to Aboriginal and Torres Strait Islander people. Aust N Z J Public Health 2019; 44:11-13. [PMID: 31825566 DOI: 10.1111/1753-6405.12958] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Rosalie Schultz
- Centre for Remote Health, Flinders University, Northern Territory
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Hickey S, Couchman K, Stapleton H, Roe Y, Kildea S. Experiences of health service providers establishing an Aboriginal-Mainstream partnership to improve maternity care for Aboriginal and Torres Strait Islander families in an urban setting. EVALUATION AND PROGRAM PLANNING 2019; 77:101705. [PMID: 31563063 DOI: 10.1016/j.evalprogplan.2019.101705] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 08/15/2019] [Accepted: 08/21/2019] [Indexed: 06/10/2023]
Abstract
Australian policy encourages multiagency partnerships between hospitals and Aboriginal Community Controlled Health Organisations to improve the health of Aboriginal and Torres Strait Islander people. Service planners remain unsure about how to implement such partnerships in maternity care, and there is a lack of appropriate tools designed to gauge the state of such partnerships for the Australian Indigenous context. In 2013, two Aboriginal health services and a major tertiary hospital partnered to deliver best practice maternity care to Indigenous families in Brisbane, Australia. A participatory action research approach underpinned this study. Semi-structured qualitative interviews and focus groups were conducted with 21 of the partnership staff. All interviewees emphasized the partnership's commitment to improving long-term health and wellbeing for Indigenous families. Strategic planners were more likely to report a positive partnership than staff involved in service delivery who had diverse views. This highlights the challenges of change management when conducting such a significant service redesign in this cross-cultural context. We detail changes made within the partnership in response to the findings and provide suggestions for future development of an evaluation tool to review the state of Aboriginal-Mainstream Partnerships.
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Affiliation(s)
- Sophie Hickey
- Midwifery Research Unit, Mater Research Institute, The University of Queensland Level 2, Aubigny Place, South Brisbane, Queensland, 4101, Australia; The Molly Wardaguga Research Centre, Charles Darwin University.
| | - Katrina Couchman
- Institute for Urban Indigenous Health, 23 Edgar Street, Bowen Hills, Queensland, 4006, Australia
| | - Helen Stapleton
- Midwifery Research Unit, Mater Research Institute, The University of Queensland Level 2, Aubigny Place, South Brisbane, Queensland, 4101, Australia
| | - Yvette Roe
- Midwifery Research Unit, Mater Research Institute, The University of Queensland Level 2, Aubigny Place, South Brisbane, Queensland, 4101, Australia; The Molly Wardaguga Research Centre, Charles Darwin University
| | - Sue Kildea
- Midwifery Research Unit, Mater Research Institute, The University of Queensland Level 2, Aubigny Place, South Brisbane, Queensland, 4101, Australia; The Molly Wardaguga Research Centre, Charles Darwin University; School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Queensland, 4072, Australia
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Turner NN, Taylor J, Larkins S, Carlisle K, Thompson S, Carter M, Redman-MacLaren M, Bailie R. Conceptualizing the Association Between Community Participation and CQI in Aboriginal and Torres Strait Islander PHC Services. QUALITATIVE HEALTH RESEARCH 2019; 29:1904-1915. [PMID: 31014184 DOI: 10.1177/1049732319843107] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Drawing from Australian Aboriginal and Torres Strait Islander perspectives, we conceptualize the association between community participation and continuous quality improvement (CQI) processes in Indigenous primary health care (PHC) services. Indigenous experiences of community participation were drawn from our study identifying contextual factors affecting CQI processes in high-improving PHC services. Using case study design, we collected quantitative and qualitative data at the micro-, meso-, and macro-health system level in 2014 and 2015 in six services in northern Australia. Analyzing qualitative data, we found community participation was an important contextual factor in five of the six services. Embedded in cultural foundations, cultural rules, and expectations, community participation involved interacting elements of trusting relationships in metaphorically safe spaces, and reciprocated learning about each other's perspectives. Foregrounding Indigenous perspectives on community participation might assist more effective participatory processes in Indigenous PHC including in CQI processes.
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Affiliation(s)
| | - Judy Taylor
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Sarah Larkins
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Karen Carlisle
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Sandra Thompson
- Western Australian Centre for Rural Health, Geraldton, Western Australia, Australia
| | - Maureen Carter
- Nindilingarri Cultural Health Services, Fitzroy Crossing, Western Australia, Australia
| | | | - Ross Bailie
- The University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia
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Kildea S, Hickey S, Barclay L, Kruske S, Nelson C, Sherwood J, Allen J, Gao Y, Blackman R, Roe YL. Implementing Birthing on Country services for Aboriginal and Torres Strait Islander families: RISE Framework. Women Birth 2019; 32:466-475. [DOI: 10.1016/j.wombi.2019.06.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 06/14/2019] [Accepted: 06/15/2019] [Indexed: 01/31/2023]
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Establishing teams aiming to provide culturally safe maternity care for Indigenous families. Women Birth 2019; 32:449-459. [DOI: 10.1016/j.wombi.2019.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 11/24/2022]
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Doran F, Wrigley B, Lewis S. Exploring cultural safety with Nurse Academics. Research findings suggest time to “step up”. Contemp Nurse 2019; 55:156-170. [DOI: 10.1080/10376178.2019.1640619] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Frances Doran
- School of Health and Human Sciences, PO Box 150, Lismore, NSW 2480, Australia
| | - Beth Wrigley
- School of Health and Human Sciences, PO Box 150, Lismore, NSW 2480, Australia
| | - Sian Lewis
- School of Health and Human Sciences, PO Box 150, Lismore, NSW 2480, Australia
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Coates D, Saleeba C, Howe D. Mental Health Attitudes and Beliefs in a Community Sample on the Central Coast in Australia: Barriers to Help Seeking. Community Ment Health J 2019; 55:476-486. [PMID: 29589218 DOI: 10.1007/s10597-018-0270-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 03/24/2018] [Indexed: 10/17/2022]
Abstract
There continues to be call for greater community awareness actions and strategies to reduce stigma and enhance mental health literacy nationally and internationally. To identify local barriers to help-seeking and perceptions around stigma, we developed a 'mental health attitudes and beliefs' survey which was administered at a range of community events on the Central Coast in New South Wales, Australia. The aim was for the results of this survey to inform the development of strategies that enhance local help-seeking behaviours that are sensitive to the role of age, gender and Indigenous status. People who approached our Mental Health Information stall were invited to complete the survey and 282 individuals completed the survey. The data was analysed descriptively with a focus on comparing subgroups based on age, gender, Indigenous status, and previous service access or experience of mental illness. Cost, stigma and mental health literacy were found to be prominent barriers to help-seeking for the overall cohort; however, the ways in which or extent to which these barriers impact on help seeking varied between subgroups. A discussion of these differences and their implications for practice is the focus of this paper.
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Affiliation(s)
- Dominiek Coates
- Faculty of Health, University of Technology Sydney, Level 11, 235 Jones St., Ultimo, NSW, 2007, Australia. .,Central Coast Mental Health Service, Central Coast Local Health District, Gosford, NSW, Australia.
| | - Christine Saleeba
- Central Coast Mental Health Service, Central Coast Local Health District, Gosford, NSW, Australia.,Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Deborah Howe
- Central Coast Mental Health Service, Central Coast Local Health District, Gosford, NSW, Australia
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Shepherd SM, Willis-Esqueda C, Newton D, Sivasubramaniam D, Paradies Y. The challenge of cultural competence in the workplace: perspectives of healthcare providers. BMC Health Serv Res 2019; 19:135. [PMID: 30808355 PMCID: PMC6390600 DOI: 10.1186/s12913-019-3959-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/18/2019] [Indexed: 12/03/2022] Open
Abstract
Background Cross-cultural educational initiatives for professionals are now commonplace across a variety of sectors including health care. A growing number of studies have attempted to explore the utility of such initiatives on workplace behaviors and client outcomes. Yet few studies have explored how professionals perceive cross-cultural educational models (e.g., cultural awareness, cultural competence) and the extent to which they (and their organizations) execute the principles in practice. In response, this study aimed to explore the general perspectives of health care professionals on culturally competent care, their experiences working with multi-cultural patients, their own levels of cultural competence and the extent to which they believe their workplaces address cross-cultural challenges. Methods The perspectives and experiences of a sample of 56 health care professionals across several health care systems from a Mid-Western state in the United States were sourced via a 19-item questionnaire. The questionnaire comprised both open-ended questions and multiple choice items. Percentages across participant responses were calculated for multiple choice items. A thematic analysis of open-ended responses was undertaken to identify dominant themes. Results Participants largely expressed confidence in their ability to meet the needs of multi-cultural clientele despite almost half the sample not having undergone formal cross-cultural training. The majority of the sample appeared to view cross-cultural education from a ‘cultural awareness’ perspective - effective cross-cultural care was often defined in terms of possessing useful cultural knowledge (e.g., norms and customs) and facilitating communication (the use of interpreters); in other words, from an immediate practical standpoint. The principles of systemic cross-cultural approaches (e.g., cultural competence, cultural safety) such as a recognition of racism, power imbalances, entrenched majority culture biases and the need for self-reflexivity (awareness of one’s own prejudices) were scarcely acknowledged by study participants. Conclusions Findings indicate a need for interventions that acknowledge the value of cultural awareness-based approaches, while also exploring the utility of more comprehensive cultural competence and safety approaches.
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Affiliation(s)
- Stephane M Shepherd
- Centre for Forensic Behavioural Science, Swinburne University of Technology, 1/582 Heidelberg Rd, Alphington, Melbourne, Victoria, Australia.
| | - Cynthia Willis-Esqueda
- Department of Psychology, University of Nebraska-Lincoln, Burnett Hall, Lincoln, NE, USA
| | - Danielle Newton
- School of Social & Political Sciences, The University of Melbourne, Gratton Street, Melbourne, Victoria, Australia
| | - Diane Sivasubramaniam
- School of Psychological Sciences, Swinburne University of Technology, John St, Hawthorn, Melbourne, Victoria, Australia
| | - Yin Paradies
- Alfred Deakin Research Institute for Citizenship and Globalisation, Deakin University, Burwood, Melbourne, Victoria, Australia
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Zubrzycki J, Shipp R, Jones V. Knowing, Being, and Doing: Aboriginal and Non-Aboriginal Collaboration in Cancer Services. QUALITATIVE HEALTH RESEARCH 2017; 27:1316-1329. [PMID: 28682709 PMCID: PMC5502907 DOI: 10.1177/1049732316686750] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This qualitative inquiry explored the processes and practices of collaboration as experienced by a group of Australian multidisciplinary Aboriginal and non-Aboriginal health workers. Each worker had participated, for a period of 2 to 5 years, in an Australian Government-funded project in which a range of health initiatives led to improved access to cancer services by Aboriginal communities in a rural region of South Eastern Australia. Initiatives which addressed high rates of mortality from cancer, poor access to cancer screening, and engagement with cancer treatment were developed through the formation of close working relationships between Aboriginal and non-Aboriginal health workers. These relationships were regarded as personally and professionally transformative. Through the sharing of knowledge, skills, and experiences, new ways of knowing, being, and doing emerged. Developing a deeper understanding of cross-cultural collaboration is one way of addressing complex health problems and building the capacity of the health workforce.
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Affiliation(s)
- Joanna Zubrzycki
- Australian Catholic University, Canberra, Australian Capital Territory, Australia
| | - Rick Shipp
- Southern NSW Local Health District, Queanbeyan, New South Wales, Australia
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Iyngkaran P, Kangaharan N, Zimmet H, Arstall M, Minson R, Thomas MC, Bergin P, Atherton J, MacDonald P, Hare DL, Horowitz JD, Ilton M. Heart Failure in Minority Populations - Impediments to Optimal Treatment in Australian Aborigines. Curr Cardiol Rev 2016; 12:166-79. [PMID: 27280307 PMCID: PMC5011191 DOI: 10.2174/1573403x12666160606115034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 12/18/2015] [Accepted: 01/11/2016] [Indexed: 01/30/2023] Open
Abstract
Chronic heart failure (CHF) among Aboriginal/Indigenous Australians is endemic. There are also grave concerns for outcomes once acquired. This point is compounded by a lack of prospective and objective studies to plan care. To capture the essence of the presented topic it is essential to broadly understand Indigenous health. Key words such as ‘worsening’, ‘gaps’, ‘need to do more’, ‘poorly studied’, or ‘future studies should inform’ occur frequently in contrast to CHF research for almost all other groups. This narrative styled opinion piece attempts to discuss future directions for CHF care for Indigenous Australians. We provide a synopsis of the problem, highlight the treatment gaps, and define the impediments that present hurdles in optimising CHF care for Indigenous Australians.
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Affiliation(s)
- Pupalan Iyngkaran
- Cardiologist and Senior Lecturer NT Medical School, Flinders University, Tiwi, NT 0811, Australia.
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Wilson AM, Kelly J, Magarey A, Jones M, Mackean T. Working at the interface in Aboriginal and Torres Strait Islander health: focussing on the individual health professional and their organisation as a means to address health equity. Int J Equity Health 2016; 15:187. [PMID: 27855703 PMCID: PMC5114820 DOI: 10.1186/s12939-016-0476-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 11/08/2016] [Indexed: 11/10/2022] Open
Abstract
Background Aboriginal and Torres Strait Islander people experience inequity in health outcomes in Australia. Health care interactions are an important starting place to seek to address this inequity. The majority of health professionals in Australia do not identify as Aboriginal and/or Torres Strait Islander people and the health care interaction therefore becomes an example of working in an intercultural space (or interface). It is therefore critical to consider how health professionals may maximise the positive impact within the health care interaction by skilfully working at the interface. Methods Thirty-five health professionals working in South Australia were interviewed about their experiences working with Aboriginal people. Recruitment was through purposive sampling. The research was guided by the National Health and Medical Research Council Values and Ethics for undertaking research with Aboriginal communities. Critical social research was used to analyse data. Results Interviews revealed two main types of factors influencing the experience of non-Aboriginal health professionals working with Aboriginal people at the interface: the organisation and the individual. Within these two factors, a number of sub-factors were found to be important including organisational culture, organisational support, accessibility of health services and responding to expectations of the wider health system (organisation) and personal ideology and awareness of colonisation (individual). Conclusions A health professional’s practice at the interface cannot be considered in isolation from individual and organisational contexts. It is critical to consider how the organisational and individual factors identified in this research will be addressed in health professional training and practice, in order to maximise the ability of health professionals to work with Aboriginal and Torres Strait Islander people and therefore contribute to addressing health equity.
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Affiliation(s)
- Annabelle M Wilson
- Southgate Institute for Health, Society and Equity, Flinders University of South Australia, GPO Box 2100, Adelaide, South Australia, 5001, Australia.
| | - Janet Kelly
- School of Nursing, University of Adelaide, North Terrace, Adelaide, Australia
| | - Anthea Magarey
- Nutrition and Dietetics, Flinders University of South Australia, GPO Box 2100, Adelaide, South Australia, 5001, Australia
| | - Michelle Jones
- Adjunct Research Fellow, University of South Australia, Adelaide, South Australia, 5000, Australia
| | - Tamara Mackean
- Southgate Institute for Health, Society and Equity, Flinders University of South Australia, GPO Box 2100, Adelaide, South Australia, 5001, Australia
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Bradley P, Dunn S, Lowell A, Nagel T. Acute mental health service delivery to Indigenous women: What is known? Int J Ment Health Nurs 2015; 24:471-7. [PMID: 26370896 DOI: 10.1111/inm.12161] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The Australian College of Mental Health Nurses directs that mental health nurses must 'enable cultural safety in practice, taking into account age, gender, spirituality, ethnicity and health values'. The present study is a review of the existing literature undertaken in order to identify current knowledge and knowledge gaps regarding the experience of Indigenous women in acute mental health inpatient facilities. In particular, studies that identified environments and practices promoting the development of culturally-safe healing spaces for Indigenous women, and studies that identified women's experience of seclusion, were sought. The results showed that there is little literature directly relevant to Indigenous women's experiences of inpatient mental health units in Australia. The present study consolidates existing knowledge and knowledge gaps, and advances the argument for gender-disaggregated future research. Implications for professional practice and service development are also noted.
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Affiliation(s)
- Pat Bradley
- School of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Sandra Dunn
- School of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Anne Lowell
- School of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Tricia Nagel
- Menzies School of Health Research, Darwin, Northern Territory, Australia
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Nielsen AM, Alice Stuart L, Gorman D. Confronting the cultural challenge of the whiteness of nursing: Aboriginal registered nurses’ perspectives. Contemp Nurse 2015. [DOI: 10.1080/10376178.2014.11081940] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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