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Fraser S, Mackean T, Grant J, Hunter K, Ryder C, Kelly J, Holland AJA, Griffin B, Clapham K, Teague WJ, Darton A, Ivers RQ. Patient journey mapping to investigate quality and cultural safety in burn care for Aboriginal and Torres Strait Islander children and families - development, application and implications. BMC Health Serv Res 2022; 22:1428. [PMID: 36443783 PMCID: PMC9703784 DOI: 10.1186/s12913-022-08754-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/29/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Quality and safety in Australian healthcare is inequitably distributed, highlighted by gaps in the provision of quality care for Aboriginal and Torres Strait Islander children. Burns have potential for long-term adverse outcomes, and quality care, including culturally safe care, is critical to recovery. This study aimed to develop and apply an Aboriginal Patient Journey Mapping (APJM) tool to investigate the quality of healthcare systems for burn care with Aboriginal and Torres Strait Islander children. STUDY DESIGN Interface research methodology, using biomedical and cultural evidence, informed the modification of an existing APJM tool. The tool was then applied to the journey of one family accessing a paediatric tertiary burn care site. Data were collected through yarning with the family, case note review and clinician interviews. Data were analysed using Emden's core story and thematic analysis methods. Reflexivity informed consideration of the implications of the APJM tool, including its effectiveness and efficiency in eliciting information about quality and cultural safety. RESULTS Through application of a modified APJM tool, gaps in quality care for Aboriginal and Torres Strait Islander children and families were identified at the individual, service and system levels. Engagement in innovative methodology incorporating more than biomedical standards of care, uncovered critical information about the experiences of culturally safe care in complex patient journeys. CONCLUSION Based on our application of the tool, APJM can identify and evaluate specific aspects of culturally safe care as experienced by Aboriginal and Torres Strait Islander peoples and be used for quality improvement.
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Affiliation(s)
- Sarah Fraser
- grid.1005.40000 0004 4902 0432School of Population Health, Faculty of Medicine, UNSW, Sydney, Australia
| | - Tamara Mackean
- grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Julian Grant
- grid.1037.50000 0004 0368 0777Charles Sturt University, Bathurst, Australia
| | - Kate Hunter
- grid.1005.40000 0004 4902 0432The George Institute for Global Health, UNSW, Sydney, Australia
| | - Courtney Ryder
- grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Janet Kelly
- grid.1010.00000 0004 1936 7304University of Adelaide, Adelaide, Australia
| | - Andrew J. A. Holland
- grid.1013.30000 0004 1936 834XThe University of Sydney, The Children’s Hospital at Westmead Clinical School, Sydney, Australia
| | - Bronwyn Griffin
- grid.1022.10000 0004 0437 5432Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Kathleen Clapham
- grid.1007.60000 0004 0486 528XUniversity of Wollongong, Wollongong, Australia
| | - Warwick J. Teague
- grid.1008.90000 0001 2179 088XUniversity of Melbourne, Melbourne, Australia
| | - Anne Darton
- Agency for Clinical Innovation, St Leonards, Willoughby, Australia
| | - Rebecca Q. Ivers
- grid.1005.40000 0004 4902 0432School of Population Health, Faculty of Medicine, UNSW, Sydney, Australia
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Ma T, Ivers R, Solar J, Simon A, de Leeuw E, Clapham K. Experiences of Older Aboriginal People in Navigating Transport Systems in an Urban Setting: An Indigenous Perspective on Transport Access, a Social Determinant of Health. Int J Environ Res Public Health 2022; 19:13778. [PMID: 36360658 PMCID: PMC9655690 DOI: 10.3390/ijerph192113778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND In Australia, Aboriginal people are underserved by the transport system and are less able to easily get to places they need to go than others. This is a part of a larger pattern of exclusion and inequity for Aboriginal people which affects their health, wellbeing, and social participation. Guided by a decolonising framework, this research explored how older Aboriginal people, whose pivotal roles in their families and communities require their mobility, experience the transportation system, providing an Indigenous-centred view of the accessibility of transportation options in society. METHODS Interviews drawing from the yarning technique were conducted with ten older Aboriginal people living in Greater Western Sydney and analysed qualitatively. RESULTS In addition to the cognitive labour required to decipher the rules of the transport system and organise commitments to match the scheduling of transport services, older Aboriginal people in this study experienced stigmatising attitudes and condescending treatment from service professionals and the public when traveling. CONCLUSIONS This study suggests three potential ways that the current trajectory that underserves older Aboriginal people could be disrupted, relating to service design, the diversity and inclusion agenda, and the social determinants of Indigenous health.
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Affiliation(s)
- Tracey Ma
- School of Population Health, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW Sydney, Sydney, NSW 2052, Australia
| | - John Solar
- School of Population Health, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Aaron Simon
- School of Population Health, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Evelyne de Leeuw
- Healthy Urban Environments Collaboratory, Maridulu Budyari Gumal SPHERE, Liverpool, NSW 2170, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW 2522, Australia
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Ma T, Kim J, Godinho MA, de Leeuw E, Clapham K, Kobel C, Ivers R. A Systematic Review with Framework Synthesis of the Ways That Urban Environments Influence Opportunities for Healthy and Sustainable Mobility in Older Age. Int J Environ Res Public Health 2022; 19:13014. [PMID: 36293626 PMCID: PMC9603098 DOI: 10.3390/ijerph192013014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/21/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Supporting older people's use of sustainable transport is important for both population health and sustainable development, especially in the context of global population ageing. This systematic review identifies individual and environmental factors that influence older people's sustainable transport use and synthesises findings using a framework approach. Factors influencing older people's walking (n = 10 studies), bus use (n = 11), community transport use (n = 1), bicycling (n = 1), and e-bicycling (n = 1) were found to be physical, geographical, facility-based, economic, time-based, fear-based, space-based, information-based, or interpersonal. Many factors were common across transport modes. One reason for this is that environmental features designed to facilitate the use of one particular transport mode also influenced the use of other modes (e.g., bus shelters influence not only bus use but also walking as they provide pedestrian seating). Thus, environments need to be considered from the perspective of multiple, different types of road users. Another reason is that many factors related to the ways individuals experienced their environment (e.g., finding information guiding behaviour in public spaces to be unclear), regardless of any specific transport mode. This review highlights the important need for greater cross-sectoral action and input from older people.
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Affiliation(s)
- Tracey Ma
- School of Population Health, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Jinhee Kim
- Centre for Health Equity Training, Research & Evaluation (CHETRE), UNSW Sydney, Sydney, NSW 2052, Australia
| | | | - Evelyne de Leeuw
- Healthy Urban Environments Collaboratory, Maridulu Budyari Gumal SPHERE, Liverpool, NSW 2170, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Conrad Kobel
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, NSW 2522, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW Sydney, Sydney, NSW 2052, Australia
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Cullen P, Mackean T, Walker N, Coombes J, Bennett-Brook K, Clapham K, Ivers R, Hackett M, Worner F, Longbottom M. Integrating Trauma and Violence Informed Care in Primary Health Care Settings for First Nations Women Experiencing Violence: A Systematic Review. Trauma Violence Abuse 2022; 23:1204-1219. [PMID: 33573523 DOI: 10.1177/1524838020985571] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
It is imperative that access to primary health care services is equitable as health care practitioners are often the first responders to women who experience violence. This is of particular importance for First Nations women who disproportionately experience interpersonal and structural violence when compared to non-First Nations women, as well as the ongoing impact of colonization, racism, and intergenerational trauma. To understand how primary health care services can provide equitable and effective care for First Nations women, we explored how trauma and violence informed care is integrated in primary health care settings through the lens of an equity-oriented framework. A systematic search of electronic databases included Medline (via Ovid), Scopus, Informit, and PubMed and grey literature. Six studies were included in the review and we undertook a narrative synthesis using the equity-oriented framework to draw together the intersection of trauma and violence informed care with culturally safe and contextually tailored care. This review demonstrates how equity-oriented primary health care settings respond to the complex and multiple forms of violence and intergenerational trauma experienced by First Nations women and thus mitigate shame and stigma to encourage disclosure and help seeking. Key attributes include responding to women's individual contexts by centering family, engaging elders, encouraging community ownership, which is driven by a culturally competent workforce that builds trust, reduces retraumatization, and respects confidentiality. This review highlights the importance of strengthening and supporting the workforce, as well as embedding cultural safety within intersectoral partnerships and ensuring adequate resourcing and sustainability of initiatives.
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Affiliation(s)
- Patricia Cullen
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, 8691University of Wollongong, Wollongong, Australia
| | - Tamara Mackean
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Natasha Walker
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
| | | | | | - Kathleen Clapham
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, 8691University of Wollongong, Wollongong, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW, Sydney, Australia
- The George Institute for Global Health, UNSW, Sydney, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Maree Hackett
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Faye Worner
- Waminda South Coast Women's Health and Welfare Aboriginal Corporation, Nowra, Australia
| | - Marlene Longbottom
- Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, 8691University of Wollongong, Wollongong, Australia
- Visiting International Scholar, School of Social Work, University of Hawai'i Manoa, HI, USA
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Ma T, de Leeuw E, Proust K, Newell B, Clapham K, Kobel C, Ivers R. Using systems thinking to assess the functioning of an "Age-Friendly City" governance network in Australia. Health Promot Int 2022; 37:6661158. [PMID: 35950893 DOI: 10.1093/heapro/daac076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Age-Friendly Cities (AFC) is a framework for promoting healthy ageing through local actions. We use systems thinking to assess potential outcomes of actions to support older people's mobility, undertaken within an AFC commitment in Greater Sydney. Interviews with 20 informants involved in providing space, infrastructure, or services that affect how older people get around were analysed using causal loop diagrams (CLDs). Four approaches to support older people's mobility were identified and situated to the Multiple Governance Framework: land use, open and public space, supplementary transport, and community transport. Analysis revealed potential for unwanted consequences associated with each, which can be generalised into three generic potential outcomes for other jurisdictions to consider. A recommendation from this research is for policy actors to examine feedback interactions between actions so that they can foresee a wider range of outcomes and take defensive action against those unwanted. By situating CLDs within the Multiple Governance Framework, this research not only identifies what to look for, in terms of potential outcomes, but also where to look, in terms of the level of decision-making. This research offers a new way to assess the functioning of AFC governance networks by their collective outcomes and challenges the standards for the evaluation of AFC.
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Affiliation(s)
- Tracey Ma
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Evelyne de Leeuw
- Centre for Health Equity Training, Research and Evaluation (CHETRE), UNSW, SWSLHD, and Ingham Institute, Liverpool, NSW, Australia
| | - Katrina Proust
- Fenner School of Environment and Society, The Australian National University, Acton, ACT, Australia
| | - Barry Newell
- Fenner School of Environment and Society, The Australian National University, Acton, ACT, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, NSW, Australia
| | - Conrad Kobel
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, NSW, Australia
| | - Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
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6
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Anderst A, Hunter K, Andersen M, Walker N, Coombes J, Raman S, Moore M, Ryan L, Jersky M, Mackenzie A, Stephensen J, Williams C, Timbery L, Doyle K, Lingam R, Zwi K, Sheppard-Law S, Erskine C, Clapham K, Woolfenden S. Screening and social prescribing in healthcare and social services to address housing issues among children and families: a systematic review. BMJ Open 2022; 12:e054338. [PMID: 35487725 PMCID: PMC9058796 DOI: 10.1136/bmjopen-2021-054338] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Housing is a social determinant of health that impacts the health and well-being of children and families. Screening and referral to address social determinants of health in clinical and social service settings has been proposed to support families with housing problems. This study aims to identify housing screening questions asked of families in healthcare and social services, determine validated screening tools and extract information about recommendations for action after screening for housing issues. METHODS The electronic databases MEDLINE, PsycINFO, EMBASE, Ovid Emcare, Scopus and CINAHL were searched from 2009 to 2021. Inclusion criteria were peer-reviewed literature that included questions about housing being asked of children or young people aged 0-18 years and their families accessing any healthcare or social service. We extracted data on the housing questions asked, source of housing questions, validity and descriptions of actions to address housing issues. RESULTS Forty-nine peer-reviewed papers met the inclusion criteria. The housing questions in social screening tools vary widely. There are no standard housing-related questions that clinical and social service providers ask families. Fourteen screening tools were validated. An action was embedded as part of social screening activities in 27 of 42 studies. Actions for identified housing problems included provision of a community-based or clinic-based resource guide, and social prescribing included referral to a social worker, care coordinator or care navigation service, community health worker, social service agency, referral to a housing and child welfare demonstration project or provided intensive case management and wraparound services. CONCLUSION This review provides a catalogue of housing questions that can be asked of families in the clinical and/or social service setting, and potential subsequent actions.
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Affiliation(s)
- Ania Anderst
- Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Kate Hunter
- Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Melanie Andersen
- Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Health, Newtown, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Natasha Walker
- Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Health, Newtown, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Julieann Coombes
- Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Shanti Raman
- Community Paediatrics, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Melinda Moore
- Sydney Children's Hospitals Network (Randwick Campus), Sydney, New South Wales, Australia
| | - Lola Ryan
- Child, Youth and Family Services, Population and Community Health, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
| | - Michelle Jersky
- Sydney Children's Hospitals Network (Randwick Campus), Sydney, New South Wales, Australia
| | - Amy Mackenzie
- Sydney Children's Hospitals Network (Randwick Campus), Sydney, New South Wales, Australia
| | - Jennifer Stephensen
- Sydney Children's Hospitals Network (Randwick Campus), Sydney, New South Wales, Australia
| | - Carina Williams
- Youth Health Services, Community Health, NSW Health, Sydney, New South Wales, Australia
| | - Lee Timbery
- Sydney Children's Hospitals Network (Randwick Campus), Sydney, New South Wales, Australia
| | - Kerrie Doyle
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Raghu Lingam
- Population Child Health Clinical Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Karen Zwi
- Sydney Children's Hospitals Network (Randwick Campus), Sydney, New South Wales, Australia
- Population Child Health Clinical Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Suzanne Sheppard-Law
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Broadway, New South Wales, Australia
| | | | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Susan Woolfenden
- Population Child Health Clinical Research Group, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
- Community Paediatrics Research Group, Institute for Women, Children and Families, Sydney Local Health District, Sydney, New South Wales, Australia
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7
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Kelly PJ, Coyte J, Robinson LD, Deane FP, Russell S, Clapham K, Dale E, Longbottom M, Solley R, Baker AL. Evaluating an Aboriginal community controlled residential alcohol and other drug services: Use of benchmarking to examine within treatment changes in wellbeing. Drug Alcohol Rev 2022; 41:953-962. [PMID: 35106858 DOI: 10.1111/dar.13432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 12/08/2021] [Accepted: 12/12/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Aboriginal Community Controlled Organisations (ACCO) have an important role in the Australian health-care sector. However, there has been a lack of research evaluating ACCOs in the treatment of alcohol and other drug (AOD) use. Using a benchmarking approach, the present study examined within treatment changes on measures of wellbeing for people attending a residential AOD ACCO. METHODS The study focused on The Glen, an AOD residential treatment service that is managed by the Ngaimpe Aboriginal Corporation (n = 775). The Glen is a male-only service and provides treatment to both Indigenous and non-Indigenous men. The evaluation focused on measures of wellbeing (i.e. symptom distress and quality of life) collected at intake, 30 and 60 days during the person's stay. Comparative benchmarking was conducted with a cohort of men who were attending non-ACCO residential AOD treatment services (n = 4457). RESULTS The Glen participants demonstrated statistically significant improvements on measures of wellbeing. The Glen participants were more likely to complete treatment than participants attending non-ACCO services. Likewise, Indigenous people attending The Glen were more likely to complete treatment (compared to Indigenous people attending non-ACCO services). Rates of reliable and clinically significant change suggested that changes in quality of life were largely equivalent between The Glen and non-ACCO services, while participants attending The Glen tended to demonstrate larger reductions in symptom distress compared to the non-ACCO services. DISCUSSION AND CONCLUSION The study provides further support for the important role that ACCOs play in supporting Indigenous people in their recovery.
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Affiliation(s)
- Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Joe Coyte
- The Glen, Central Coast Alcohol and Drug Rehabilitation Centre, Ngaimpe Aboriginal Corporation, Chittaway Point, Australia
| | - Laura D Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Sophie Russell
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Elizabeth Dale
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.,Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Marlene Longbottom
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Ryan Solley
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
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Porykali B, Cullen P, Hunter K, Rogers K, Kang M, Young N, Senserrick T, Clapham K, Ivers R. The road beyond licensing: the impact of a driver licensing support program on employment outcomes for Aboriginal and Torres Strait Islander Australians. BMC Public Health 2021; 21:2146. [PMID: 34814871 PMCID: PMC8611871 DOI: 10.1186/s12889-021-12218-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background With increasingly tough graduated driver licensing laws in all Australian States and Territories, driver licensing support programs are recognised as being important to support Aboriginal and Torres Strait Islander peoples to obtain a driver licence. Such programs appear to improve licensing attainment rates, but few studies have examined the broader impact that these programs can have. This research aims to 1) examine the impact of a New South Wales (NSW) based driver licensing support program (Driving Change) on client employment outcomes; 2) assess the influence of geographical area of program delivery on driver licence attainment. Methods Driving Change was delivered from February 2013 to August 2016 in 4 urban and 7 regional Aboriginal communities of NSW. Clients were followed-up at 6 months or more following contact with the program as part of routine program operations. Descriptive statistics and regression models were used to analyse data. Results From 933 clients contacted 254 agreed to provide feedback, a response rate of 27%. Those that responded were mostly female (57%), aged 24 years and under (72%), unemployed (85%) with secondary education or less (71%) and from a regional area (74%). Adjusted logistic regression indicated that clients who achieved an independent licence were more likely (OR: 2.5, 95% CI: 1.22–5.24, p = 0.011) of reporting a new job or change in job than those who did not attain a licence. Clients from regional areas were more likely (OR: 1.72, 95% CI: 1.27–2.33, p < 0.001) to gain an independent licence than those from urban areas. There was no difference in employment outcomes (OR: 1.2, 95% CI: 0.53–2.52, p = 0.719) for clients from urban compared to regional areas. Conclusion The Driving Change program appears to be effective in improving employment outcomes for those who gained a licence. Clients from regional areas were more likely to gain a licence compared to those in urban settings, and were predominantly young and unemployed, often a hard to reach cohort. Future licensing programs being delivered in regional areas need integrated pathways into employment opportunities to provide holistic services that address the social and economic challenges faced by Aboriginal and Torres Strait Islander Australians.
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Affiliation(s)
- Bobby Porykali
- School of Public Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia. .,The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW, 2042, Australia.
| | - Patricia Cullen
- The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW, 2042, Australia.,School of Population Health, University of New South Wales, Sydney, NSW, 2052, Australia.,Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Kate Hunter
- The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW, 2042, Australia.,School of Population Health, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Kris Rogers
- School of Public Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.,The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW, 2042, Australia
| | - Melissa Kang
- School of Public Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia
| | - Nareen Young
- School of Public Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia
| | - Teresa Senserrick
- Queensland University of Technology, 130 Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - Kathleen Clapham
- The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW, 2042, Australia.,Ngarruwan Ngadju, First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Rebecca Ivers
- School of Public Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.,The George Institute for Global Health, Level 5, 1 King Street, Newtown, NSW, 2042, Australia.,School of Population Health, University of New South Wales, Sydney, NSW, 2052, Australia
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9
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Fraser S, Grant J, Mackean T, Hunter K, Keeler N, Clapham K, Edgar DW, Towers K, Teague WJ, Ivers R. Considering difference: clinician insights into providing equal and equitable burns care for Aboriginal and Torres Strait Islander children. Aust N Z J Public Health 2021; 45:220-226. [PMID: 34028905 DOI: 10.1111/1753-6405.13110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To better understand issues driving quality in burn care related to equity of outcomes and equality of provision for Aboriginal and Torres Strait Islander children. METHODS Seventy-six interviews with team members who provide care for Aboriginal and Torres Strait Islander children in six paediatric burn units across five Australian jurisdictions were completed. Interface research methodology within a qualitative design guided data collection and analysis. RESULTS Three themes were identified: i) Burn team members who identify the requirement to meet the specific needs of Aboriginal and Torres Strait Islander children and deliver differential care; ii) Burn team members who believe in equal care, but deliver differential care based on the specific needs of Aboriginal and Torres Strait Islander children; and iii) Burn team members who see little need for provision of differential care for Aboriginal and Torres Strait Islander children and rather, value the provision of equal care for all. CONCLUSION Burn team members conflate equitable and equal care, which has implications for the delivery of care for Aboriginal and Torres Strait Islander children. Equitable care is needed to address disparities in post-burn outcomes, and this requires clinicians, healthcare services and relevant system structures to work coherently and intentionally to reflect these needs. Implications for public health: Changes in health policy, the embedding of Aboriginal and Torres Strait Islander liaison officers in burn care teams and systems that prioritise critical reflexive practice are fundamental to improving care.
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Affiliation(s)
- Sarah Fraser
- Faculty of Medicine and Health, The University of New South Wales
| | - Julian Grant
- School of Nursing, Midwifery and Indigenous Health, Faculty of Science, Charles Sturt University, New South Wales
| | - Tamara Mackean
- College of Medicine and Public Health, Flinders University, South Australia
| | - Kate Hunter
- The George Institute for Global Health; Faculty of Medicine, The University of New South Wales, New South Wales
| | | | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, University of Wollongong
| | - Dale W Edgar
- Burn Service of Western Australia, Fiona Stanley Hospital; The Institute for Health Research, The University of Notre Dame Australia
| | - Kurt Towers
- Northern Adelaide Local Health Network, South Australia
| | - Warwick J Teague
- Burns Service, The Royal Children's Hospital, Melbourne, Victoria; Department of Paediatrics, University of Melbourne, Melbourne, Victoria
| | - Rebecca Ivers
- Faculty of Medicine and Health, The University of New South Wales
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10
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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11
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Dale E, Conigrave KM, Kelly PJ, Ivers R, Clapham K, Lee KSK. A Delphi yarn: applying Indigenous knowledges to enhance the cultural utility of SMART Recovery Australia. Addict Sci Clin Pract 2021; 16:2. [PMID: 33407873 PMCID: PMC7787604 DOI: 10.1186/s13722-020-00212-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mutual support groups are a popular treatment for substance use and other addictive behaviours. However, little is known about the cultural utility of these programmes for Indigenous peoples. METHODS A three-round Delphi study, utilising Indigenous research yarning methods was conducted to: (1) Obtain expert opinion regarding the cultural utility of an Indigenous SMART Recovery handbook; (2) Gain consensus on areas within the SMART Recovery programme that require cultural modification and; (3) Seek advice on how modifications could be implemented in future programme design and delivery. The panellists were 11 culturally, geographically, and professionally diverse Indigenous Australian health and wellbeing experts. A group consensus level of 80% was set prior to each survey round. RESULTS There was 100% participant retention across all three Delphi rounds. The panel reached consensus on five key programme modifications (composition of a separate facilitator and group member handbook; culturally appropriate language, terminology, and literacy level; culturally meaningful programme activities; supplementary storytelling resources; and customisation for diverse community contexts). The panel also developed a series of practical implementation strategies to guide SMART Recovery through a modification process. CONCLUSION The findings highlight the importance of involving Indigenous peoples in the design, delivery and validation of mainstream mutual support programmes. Indigenous-led programme modifications could help improve accessibility and usefulness of mutual support groups for Indigenous peoples worldwide. This study is an example of how Indigenous research methods can be used alongside the Delphi technique. This approach demonstrated a way that Indigenous peoples from culturally and geographically diverse locations can participate in research anonymously, autonomously and without added burden on personal, community or professional obligations.
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Affiliation(s)
- Elizabeth Dale
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia.
- School of Psychology, University of Wollongong, Wollongong, NSW, 2500, Australia.
| | - Katherine M Conigrave
- Royal Prince Alfred Hospital, Drug Health Services, Camperdown, NSW, Australia
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Camperdown, NSW, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- School of Psychology, University of Wollongong, Wollongong, NSW, 2500, Australia
| | - Rowena Ivers
- Gradute School of Medicine, The University of Wollongong, Wollongong, NSW, Australia
- Illawarra Aboriginal Medical Service, Wollongong, NSW, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, Faculty of Business, University of Wollongong, Wollongong, NSW, Australia
| | - K S Kylie Lee
- Royal Prince Alfred Hospital, Drug Health Services, Camperdown, NSW, Australia
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
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12
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Macniven R, Coombes J, Wilson R, Simon A, Mackean T, Hunter K, Ma T, Gwynn J, Sherrington C, Tiedemann A, Hill AM, Delbaere K, Lewis C, Bennett-Brook K, Howie A, Stewart G, Shakespeare M, Rogers K, Ivers RQ, Clapham K. Understanding implementation factors and participant experiences of a cluster randomised controlled trial to prevent falls among older Aboriginal people: a process evaluation protocol. Inj Prev 2021; 27:injuryprev-2020-043980. [PMID: 33402353 DOI: 10.1136/injuryprev-2020-043980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Process evaluations examining programme implementation are often conducted in conjunction with effectiveness studies. Their inclusion in studies with Aboriginal participants can give an understanding of programme delivery in Aboriginal community contexts. The Ironbark: Standing Strong and Tall programme was codesigned with Aboriginal communities and includes exercise and facilitated 'yarning' discussion about fall risk and prevention strategies. The programme pilot showed favourable outcomes and acceptability for Aboriginal people aged 45 years and over. The Ironbark: Standing Strong and Tall programme is now being compared with a 'Healthy Community' programme in a cluster randomised controlled trial within Aboriginal health and community services. An embedded process evaluation aims to explore relationships between participation and programme outcomes and the quality of programme implementation. METHODS AND ANALYSIS The process evaluation will use a mixed methods design, guided by Indigenous research methodology. It will evaluate quantitative data (number of completed sessions, site coaching checklist tool, participant and facilitator questionnaire data and a participant habit formation scale), as well as qualitative data (open-ended responses from project and site staff and semistructured interviews using yarning with study participants and site managers). A programme logic model was developed to explain the intended inputs, activities, outputs and outcomes, which guided this process evaluation design. CONCLUSION This process evaluation of a fall prevention programme for older Aboriginal people using a mixed methods design and data triangulation will allow for a comprehensive understanding of study findings. Multiple study sites allow for generalisability of findings and exploration of variation across sites. TRIAL REGISTRATION NUMBER ACTRN12619000349145.
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Affiliation(s)
- Rona Macniven
- School of Population Health, The University of New South Wales, Sydney, New South Wales, Australia
- Poche Centre for Indigenous Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Julieann Coombes
- The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Roland Wilson
- Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide, South Australia, Australia
| | - Aaron Simon
- School of Population Health, The University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Tamara Mackean
- The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
- Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide, South Australia, Australia
| | - Kate Hunter
- The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Tracey Ma
- School of Population Health, The University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Josephine Gwynn
- Poche Centre for Indigenous Health, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, School of Public Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, School of Public Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Anne-Marie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Perth, Australia
| | - Kim Delbaere
- School of Population Health, The University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, University of New South Wales, Sydney, New South Wales, Australia
| | - Carolyn Lewis
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Perth, Australia
| | - Keziah Bennett-Brook
- The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Adam Howie
- School of Population Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Georgia Stewart
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Madison Shakespeare
- Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide, South Australia, Australia
| | - Kris Rogers
- The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
- Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Rebecca Q Ivers
- School of Population Health, The University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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13
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Ivers R, Coombes J, Sherrington C, Mackean T, Tiedemann A, Hill AM, Keay L, Clemson L, Simpson J, Ryder C, Macniven R, Clapham K. Healthy ageing among older Aboriginal people: the Ironbark study protocol for a cluster randomised controlled trial. Inj Prev 2020; 26:581-587. [PMID: 33028649 DOI: 10.1136/injuryprev-2020-043915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/31/2020] [Accepted: 09/04/2020] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Older Aboriginal people have a strong leadership role in their community including passing on knowledge and teachings around culture and connections to Country. Falls significantly affect older people and are a growing concern for older Aboriginal people and their families. Regular participation in balance and strength exercise has been shown to be efficacious in reducing falls. A pilot study developed in partnership with Aboriginal communities, the Ironbark: Standing Strong and Tall programme, demonstrated high community acceptability and feasibility, and gains in balance and strength in Aboriginal participants. This cluster randomised controlled trial will assess the effectiveness of the programme in reducing the rate of falls in older Aboriginal people. METHODS We will examine the effectiveness and cost-effectiveness of the Ironbark group-based fall prevention programme compared with a group-based social programme, with Aboriginal people aged 45 years and older in three Australian states. The primary outcome is fall rates over 12 months, measured using weekly self-reported data. Secondary outcomes measured at baseline and after 12 months include quality of life, psychological distress, activities of daily living, physical activity, functional mobility and central obesity. Differences between study groups in the primary and secondary outcomes at 12 months will be estimated. CONCLUSION This is the first trial to investigate the effectiveness and cost-effectiveness of a fall prevention programme for Aboriginal peoples aged ≥45 years. The study has strong cultural and community governance, including Aboriginal investigators and staff, and is guided by a steering committee that includes representatives of Aboriginal community-controlled services. TRIAL REGISTRATION NUMBER ACTRN12619000349145.
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Affiliation(s)
- Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia .,The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Julieann Coombes
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, School of Public Health, The University of Sydney and Sydney Local Health District, Sydney, Australia, Sydney, New South Wales, Australia
| | - Tamara Mackean
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide, South Australia, Australia
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, School of Public Health, The University of Sydney and Sydney Local Health District, Sydney, Australia, Sydney, New South Wales, Australia
| | - Anne-Marie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Lisa Keay
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Lindy Clemson
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Judy Simpson
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Courtney Ryder
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide, South Australia, Australia
| | - Rona Macniven
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,Poche Centre for Indigenous Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, The University of Wollongong, Wollongong, New South Wales, Australia
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14
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Ma T, Peden AE, Peden M, Hyder AA, Jagnoor J, Duan L, Brown J, Passmore J, Clapham K, Tian M, Rahman AKMF, Ivers RQ. Out of the silos: embedding injury prevention into the Sustainable Development Goals. Inj Prev 2020; 27:166-171. [PMID: 32917743 DOI: 10.1136/injuryprev-2020-043850] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/09/2020] [Accepted: 08/14/2020] [Indexed: 12/25/2022]
Abstract
Globally, unintentional injuries contribute significantly to disability and death. Prevention efforts have traditionally focused on individual injury mechanisms and their specific risk factors, which has resulted in slow progress in reducing the burden. The Sustainable Development Goals (SDGs) represent a global agenda for promoting human prosperity while respecting planetary boundaries. While injury prevention is currently only recognised in the SDG agenda via two road safety targets, the relevance of the SDGs for injury prevention is much broader. In this State of the Art Review, we illustrate how unintentional injury prevention efforts can be advanced substantially within a broad range of SDG goals and advocate for the integration of safety considerations across all sectors and stakeholders. This review uncovers injury prevention opportunities within broader global priorities such as urbanisation, population shifts, water safeguarding and corporate social responsibility. We demonstrate the relevance of injury prevention efforts to the SDG agenda beyond the health goal (SDG 3) and the two specific road safety targets (SDG 3.6 and SDG 11.2), highlighting 13 additional SDGs of relevance. We argue that all involved in injury prevention are at a critical juncture where we can continue with the status quo and expect to see more of the same, or mobilise the global community in an 'Injury Prevention in All Policies' approach.
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Affiliation(s)
- Tracey Ma
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Amy E Peden
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Margaret Peden
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, Imperial College London, London, UK
| | - Adnan A Hyder
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Leilei Duan
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Julie Brown
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Jonathon Passmore
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Maoyi Tian
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, Peking University Health Science Center, Beijing, China
| | - A K M Fazlur Rahman
- The Centre for Injury Prevention and Research, Bangladesh, Dhaka, Bangladesh.,Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Rebecca Q Ivers
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia .,The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
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15
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Walker N, Mackean T, Longbottom M, Coombes J, Bennett-Brook K, Clapham K, Ivers R, Hackett M, Redfern J, Cullen P. Responses to the primary health care needs of Aboriginal and Torres Strait Islander women experiencing violence: A scoping review of policy and practice guidelines. Health Promot J Austr 2020; 32 Suppl 2:40-53. [PMID: 32894883 DOI: 10.1002/hpja.417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 08/25/2020] [Accepted: 08/29/2020] [Indexed: 11/06/2022] Open
Abstract
ISSUE ADDRESSED It is demonstrated that primary health care (PHC) providers are sought out by women who experience violence. Given the disproportionate burden of violence experienced by Aboriginal and Torres Strait Islander women, it is essential there is equitable access to appropriate PHC services. This review aimed to analyse whether Australian PHC policy accounts for the complex needs of Aboriginal and Torres Strait Islander women experiencing violence and the importance of PHC providers responding to violence in culturally safe ways. METHODS Using the Arskey and O'Malley framework, an iterative scoping review determined the policies for analysis. The selected policies were analysed against concepts identified as key components in responding to the needs of Aboriginal and Torres Strait Islander women experiencing violence. The key components are Family Violence, Violence against Aboriginal and Torres Strait Islander Women, Social Determinants of Aboriginal and Torres Strait Islander Health and Wellbeing, Cultural Safety, Holistic Health, Trauma, Patient-Centred Care and Trauma-and-Violence-Informed Care. RESULTS Following a search of Australian government websites, seven policies were selected for analysis. Principally, no policy embedded or described best practice across all key components. CONCLUSION The review demonstrates the need for a specific National framework supporting Aboriginal and Torres Strait Islander women who seek support from PHC services, as well as further policy analysis and review. SO WHAT?: Aboriginal and Torres Strait Islander women disproportionately experience more severe violence, with complex impact, than other Australian women. PHC policy and practice frameworks must account for this, together with the intersection of contemporary manifestations of colonialism and historical and intergenerational trauma.
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Affiliation(s)
- Natasha Walker
- School of Population Health, UNSW, Sydney, NSW, Australia.,The George Institute for Global Health, UNSW, Sydney, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Tamara Mackean
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Marlene Longbottom
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, Australia.,Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Julieann Coombes
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia
| | | | - Kathleen Clapham
- Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, Australia.,Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Rebecca Ivers
- School of Population Health, UNSW, Sydney, NSW, Australia.,The George Institute for Global Health, UNSW, Sydney, NSW, Australia
| | - Maree Hackett
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia.,Faculty of Medicine, UNSW, Sydney, NSW, Australia.,School of Sport and Health Services, The University of Central Lancashire, Preston, UK
| | - Julie Redfern
- The George Institute for Global Health, UNSW, Sydney, NSW, Australia.,Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia
| | - Patricia Cullen
- School of Population Health, UNSW, Sydney, NSW, Australia.,The George Institute for Global Health, UNSW, Sydney, NSW, Australia.,Ngarruwan Ngadju: First Peoples Health and Wellbeing Research Centre, University of Wollongong, Wollongong, NSW, Australia
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16
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Ma T, Ivers R, de Leeuw E, Clapham K, Kobel C. Health in cities: Getting out and about as we age. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Transportation influences health through its effects on people's access to goods, services, and life chance opportunities; social interactions; physical activity levels; air pollution exposures; and road injury risks. Given the ageing of populations, it is essential that decisions about land use and transportation systems are appropriate to meet the mobility needs of older people and support healthy ageing. Not all transportation options, however, may be accessible to older people. Factors that affect accessibility relate to the spatial and physical characteristics of places, personal and social contexts of individuals, and rules and norms underpinning planning and policy making.
This research aimed to understand how different parts and processes of urban systems interact to influence transportation options for older people. Using the Greater Sydney area as a case, we drew on key informant interviews and public policy documents to identify the considerations that inform planning and policy making as they pertain to the nature of cities and the opportunities of older people to get out and about. We compared and integrated these findings with peer-reviewed literature of similar urban growth areas.
Our analysis mapped the factors of the human-urban system that are central to enabling transportation mobility for older people, articulated their interrelationships, and identified the actors that influence them. Our results point to the involvement of actors from the public health, community development, transportation, and urban planning sectors at multiple levels of government. Each of these actors operate within their own remit to influence a part of the urban system relevant to older people's transportation, such as the zoning of land, the approval of housing developments, and the location of bus stops. However, these individual actions are constrained by others in the system. We interpret this complexity with a governance lens.
Key messages
Efforts to promote mobility in old age should move beyond ‘single solutions to single issues’ approaches toward those that reflect the complexity of cities and the ways that people move within them. For sustained realization of desired outcomes, age-friendly initiatives cannot occur in isolation, but rather must take into account the behaviours and dynamics of the urban system.
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Affiliation(s)
- T Ma
- School of Public Health and Community Medicine, UNSW Sydney, Kensington, Australia
| | - R Ivers
- School of Public Health and Community Medicine, UNSW Sydney, Kensington, Australia
| | - E de Leeuw
- Centre for Health Equity Training, Research & Evaluation, UNSW Sydney Research Centre for Primary Health Care & Equity, Liverpool, Australia
| | - K Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research, University of Wollongong, Wollongong, Australia
| | - C Kobel
- Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
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Williams HM, Hunter K, Clapham K, Ryder C, Kimble R, Griffin B. Efficacy and cultural appropriateness of psychosocial interventions for paediatric burn patients and caregivers: a systematic review. BMC Public Health 2020; 20:284. [PMID: 32131784 PMCID: PMC7057463 DOI: 10.1186/s12889-020-8366-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/17/2020] [Indexed: 11/21/2022] Open
Abstract
Background Paediatric burns are highly painful and traumatising injuries that are overrepresented among Aboriginal and Torres Strait Islander people. Paediatric burn patients’ pain remains poorly managed by pharmacological interventions, leading to increased anxiety, distress, and trauma in patients and their caregivers. Non-pharmacological psychosocial interventions have been suggested as effective in reducing pain and psychological morbidities among paediatric burn patients and their caregivers; however, their degree of effectiveness and appropriateness for Aboriginal and Torres Strait Islander people is unclear. Methods A non-date restricted systematic review was conducted through four databases. Studies published in English assessing psychosocial interventions on paediatric burn patients’ physical pain along with theirs and/or their caregiver’s anxiety, distress, or trauma symptoms were identified and included in this review. Included studies were assessed for their ability to reduce one of the outcomes of interests and for their reflection of Aboriginal and Torres Strait Islander peoples’ perspectives of health. Results Of the 3178 identified references, 17 were eligible. These include distraction based techniques (n = 8), hypnosis/familiar imagery (n = 2), therapeutic approaches (n = 4), and patient preparation/procedural control (n = 3). Distraction techniques incorporating procedural preparation reduced pain, while discharge preparation and increased ‘patient control’ reduced patient and caregiver anxiety; and internet based Cognitive Behaviour Therapy reduced short-term but not long-term post-traumatic stress symptoms. No interventions reflected Aboriginal and Torres Strait Islander peoples’ perspectives of health; and few targeted caregivers or focused on reducing their symptoms. Conclusions The development and assessment of psychosocial interventions to appropriately meet the needs of Aboriginal and Torres Strait Islander paediatric burn patients is required.
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Affiliation(s)
- H M Williams
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, Graham Street, South Brisbane, 4101, QLD, Australia. .,Pegg Leditschke Paediatric Burns Centre, Queensland Children's Hospital, Graham Street, South Brisbane, QLD, 4101, Australia.
| | - K Hunter
- Injury Division, The George Institute for Global Health, University of New South Wales, King Street, Sydney, 2042, NSW, Australia
| | - K Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, The University of Wollongong, Wollongong, 2522, NSW, Australia
| | - C Ryder
- Injury Division, The George Institute for Global Health, University of New South Wales, King Street, Sydney, 2042, NSW, Australia.,College of Medicine & Public Health, Southgate Institute for Health Society and Equity, Flinders University, Registry Road, Bedford Park, 5042, SA, Australia
| | - R Kimble
- Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, Graham Street, South Brisbane, 4101, QLD, Australia.,Pegg Leditschke Paediatric Burns Centre, Queensland Children's Hospital, Graham Street, South Brisbane, QLD, 4101, Australia
| | - B Griffin
- Pegg Leditschke Paediatric Burns Centre, Queensland Children's Hospital, Graham Street, South Brisbane, QLD, 4101, Australia.,School of Nursing, Queensland University of Technology, Ring Road, Brisbane, 4059, QLD, Australia
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18
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Dale E, Kelly PJ, Lee KSK, Conigrave JH, Ivers R, Clapham K. Systematic review of addiction recovery mutual support groups and Indigenous people of Australia, New Zealand, Canada, the United States of America and Hawaii. Addict Behav 2019; 98:106038. [PMID: 31302311 DOI: 10.1016/j.addbeh.2019.106038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/10/2019] [Accepted: 06/25/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Addictions contribute significantly to the overall disease burden for Indigenous peoples of colonised countries. Mutual support groups are one of the most common addiction recovery resources, however their effectiveness for Indigenous peoples is unclear. METHODS A PRISMA-informed search was performed to retrieve empirical studies on addiction recovery mutual support groups for Indigenous peoples of Australia, New Zealand, Canada, United States of America and Hawaii. Databases searched were: MEDLINE, CINAHL Plus, PsychINFO, PsychARTICLES, SocINDEX, Cochrane Database of Systematic Reviews, PubMed, Scopus and UlrichsWeb, Informit Collections, Australian Indigenous HealthInfonet and Lowitja Institute electronic databases. Exclusion criteria were: 1) not an Indigenous focus; 2) not an addiction focus (i.e. including alcohol, other drug, gambling); 3) not a mutual support group focus; 4) not an original study; 5) not a complete study; 6) not published in English language. RESULTS Four studies published between 2001 and 2006 met review criteria. All studies were conducted in the United States of America with Native American Indian peoples (n = 1600) and featured Alcoholics Anonymous only. Study designs were: a retrospective analysis of survey data, a cross-sectional survey report, a clinical case study and an ethnographic study. Methodological differences precluded meaningful translation of results. CONCLUSION There is a lack of empirical knowledge on the acceptability and outcomes of addiction recovery mutual support groups for Indigenous peoples of Australia, New Zealand, Canada, United States of America and Hawaii. This review suggests recommendations for future research.
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Affiliation(s)
- Elizabeth Dale
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Center, Australian Health Services Research Institute and Illawarra Health and Medical Research Institute, School of Psychology, University of Wollongong, New South Wales, Australia.
| | - Peter J Kelly
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Center, Australian Health Services Research Institute and Illawarra Health and Medical Research Institute, School of Psychology, University of Wollongong, New South Wales, Australia
| | - K S Kylie Lee
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, New South Wales, Australia; La Trobe University, Centre for Alcohol Policy Research, Victoria, Australia
| | - James H Conigrave
- The University of Sydney, Faculty of Medicine and Health, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, New South Wales, Australia
| | - Rowena Ivers
- School of Medicine, The University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Aboriginal Medical Service, New South Wales, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Center, Australian Health Services Research Institute, Faculty of Business, University of Wollongong, New South Wales, Australia
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19
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Williamson A, Gibberd A, Hanly MJ, Banks E, Eades S, Clapham K, Falster K. Social and emotional developmental vulnerability at age five in Aboriginal and non-Aboriginal children in New South Wales: a population data linkage study. Int J Equity Health 2019; 18:120. [PMID: 31366368 PMCID: PMC6668060 DOI: 10.1186/s12939-019-1019-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 07/21/2019] [Indexed: 11/10/2022] Open
Abstract
Background Early childhood social and emotional development underpins later social, emotional, academic and other outcomes. The first aim of this study was to explore the association between child, family and area-level characteristics associated with developmental vulnerability, amongst Aboriginal and non-Aboriginal children in their first year of school. The second aim was to quantify the magnitude of the social and emotional developmental inequalities between Aboriginal and non-Aboriginal children and the extent to which differences in socioeconomic disadvantage and perinatal characteristics explained this inequality. Methods This retrospective cohort study used cross-sectoral data linkage to identify and follow participants from birth to school age. In this way, social and emotional development was examined in 7,384 Aboriginal and 95,104 non-Aboriginal children who were included in the Australian Early Development Census in their first year of full-time school in New South Wales (NSW) in 2009 or 2012 and had a birth registration and/or perinatal record in NSW. The primary outcome measures were teacher-reported social competence and emotional maturity as measured using the Australian version of the Early Development Instrument. Results The mean age at the start of the school year for children in the study sample was 5.2 years (SD = 0.36 years). While 84% of Aboriginal children scored favourably - above the vulnerability threshold – for social competence and 88% for emotional maturity, Aboriginal children were twice as likely as non-Aboriginal children to be vulnerable on measures of social development (RR = 2.00; 95%CI, 1.89–2.12) and had 89% more risk of emotional vulnerability (RR = 1.89; 95%CI, 1.77–2.02). The inequality between Aboriginal and non-Aboriginal children was largely explained by differences in the socioeconomic and perinatal health characteristics of children and families. Thus, after adjusting for differences in measures of socioeconomic advantage and disadvantage (Model 2), the relative risk was attenuated to 1.31 (95% CI: 1.23–1.40) on the social competence domain and 1.24 (95% CI, 1.15–1.33) on the emotional maturity domain. Child, family and area-level characteristics associated with vulnerability were identified. Conclusions Most of the gap in early childhood social and emotional development between Aboriginal and non-Aboriginal children can be attributed to socioeconomic and early life health disadvantage. Culturally safe health and social policies addressing the socioeconomic and health inequalities experienced by Aboriginal children are urgently required. Electronic supplementary material The online version of this article (10.1186/s12939-019-1019-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Williamson
- The Sax Institute, PO Box K617, Haymarket, NSW, 1240, Australia.
| | - Alison Gibberd
- Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia
| | - Mark J Hanly
- Centre for Big Data Research in Health, University of New South Wales, Kensington, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.,The Sax Institute, PO Box K617, Haymarket, NSW, 1240, Australia
| | - Sandra Eades
- Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, Australia
| | - Kathleen Falster
- Centre for Big Data Research in Health, University of New South Wales, Kensington, Australia.,National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.,Centre for Social Research Methods, Australian National University, Canberra, Australia
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20
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Longbottom M, McGlade H, Langton M, Clapham K. Indigenous Australian children and the impact of adoption legislation in New South Wales. Lancet 2019; 393:1499-1500. [PMID: 30983582 DOI: 10.1016/s0140-6736(19)30252-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 01/14/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Marlene Longbottom
- Australian Health Services Research Institute, University of Wollongong, Wollongong NSW 2522, Australia.
| | - Hannah McGlade
- School of Media, Creative Arts and Social Inquiry, Curtin University, Perth, Australia
| | - Marcia Langton
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, Wollongong NSW 2522, Australia
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21
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Cullen P, Hunter K, Clapham K, Senserrick T, Rogers K, Harrison JE, Ivers RQ. Road user behaviour, attitudes and crashes: a survey of Aboriginal and Torres Strait Islander people in Australia. Inj Prev 2019; 26:123-128. [PMID: 30837328 DOI: 10.1136/injuryprev-2018-043011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study aimed to describe road user behaviour, attitudes and crashes in Aboriginal and Torres Strait Islander people in four urban, regional and remote communities located in New South Wales (NSW) and South Australia (SA). METHODS Face-to-face surveys were administered to clients (n=625) in Aboriginal Community Controlled Health Services (ACCHS). All Aboriginal and Torres Strait Islander clients attending the ACCHS for any reason were approached to participate over a 2-week period. Surveys included questions on sociodemographic factors, crash involvement, road behaviours and road safety attitudes drawn from tools used in national surveys. RESULTS The participation rate was high (69%-75%). Seat belt wearing rates were very high, particularly in the front of a car, although rear seat belt wearing rates in SA (77%) were substantially lower than in NSW (93%). Among drivers, 11% reported always or mostly driving 10 km/hour over the speed limit, and this was higher among drivers in SA (13.4%). Drivers aged 55 years and over and/or women were more likely to report that they do not drink at any time or restricted what they drank when driving. These results enable comparison with the Community Attitude to Road Safety survey conducted Australia-wide in 2013. CONCLUSIONS This study confirms that Aboriginal and Torres Strait Islander people are inclined to report attitudes or road safety behaviours similar to the rest of the population; however, rear restraint use was lower and self-reported speeding was higher. These issues are likely attributable to transport options and geography in remote communities, which can contribute to overcrowding and unsafe driving practices.
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Affiliation(s)
- Patricia Cullen
- School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia.,The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
| | - Kate Hunter
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, Australia
| | - Teresa Senserrick
- Centre for Accident Research and Road Safety-Queensland (CARRS-Q), Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Transport and Road Safety Research, UNSW, Sydney, New South Wales, Australia
| | - Kris Rogers
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia.,Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - James E Harrison
- College of Medicine & Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia .,The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia.,Southgate Institute, Flinders University, Adelaide, South Australia, Australia
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22
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Ryder C, Mackean T, Hunter K, Williams H, Clapham K, Holland AJA, Ivers R. Equity in functional and health related quality of life outcomes following injury in children - a systematic review. Critical Public Health 2019. [DOI: 10.1080/09581596.2019.1581918] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Courtney Ryder
- The George Institute for Global Health, UNSW, Sydney, Australia
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, Australia
| | - Tamara Mackean
- The George Institute for Global Health, UNSW, Sydney, Australia
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, Australia
| | - Kate Hunter
- The George Institute for Global Health, UNSW, Sydney, Australia
| | - Hayley Williams
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Andrew J. A. Holland
- Discipline of Child & Adolescent Health, The Children’s Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, UNSW, Sydney, Australia
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, Australia
- School of Public Health and Community Medicine, UNSW, Sydney, Australia
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23
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Möller H, Ivers R, Clapham K, Jorm L. Are we closing the Aboriginal child injury gap? A cohort study. Aust N Z J Public Health 2019; 43:15-17. [PMID: 30720921 DOI: 10.1111/1753-6405.12866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/01/2018] [Accepted: 11/01/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To assess if rates of hospitalised injury in Australian Aboriginal children, and differences in these rates between Aboriginal and non-Aboriginal children, have changed over time. METHODS We used linked hospital data for New South Wales (NSW), Australia, to construct cohorts of children born in NSW hospitals between 2003-2007 and 2008-2012. We calculated rates of hospitalised injuries per 10,000 person years for Aboriginal and non-Aboriginal children for both cohorts, and compared these using rate differences and rate ratios. RESULTS Rates of unintentional injury hospitalisation were similar in Aboriginal children in both cohorts and Aboriginal children had 1.7 times higher rates of unintentional injury hospitalisation compared with non-Aboriginal children. Rate ratios between Aboriginal and non-Aboriginal children for leading injury mechanisms, burns, poisonings and transport were similar in both cohorts, with 2.5, 3.0 and 2.4 times higher rates in Aboriginal children in the 2008-2012 cohort, respectively. Conclusions and Implications for public health: Our findings suggest that current injury prevention measures have not been successful in reducing either rates of unintentional injury in Aboriginal children, or injury inequalities between Aboriginal and non-Aboriginal children. We recommend the implementation of targeted Aboriginal led injury prevention measures.
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Affiliation(s)
| | - Rebecca Ivers
- The George Institute for Global Health.,School of Public Health & Community Medicine, UNSW
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong
| | - Louisa Jorm
- Centre for Big Data Research in Health, UNSW
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24
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Young C, Craig JC, Clapham K, Banks S, Williamson A. The prevalence and protective factors for resilience in adolescent Aboriginal Australians living in urban areas: a cross‐sectional study. Aust N Z J Public Health 2018; 43:8-14. [DOI: 10.1111/1753-6405.12853] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 10/27/2022] Open
Affiliation(s)
- Christian Young
- Centre for Kidney Research, The Children’s Hospital at Westmead, New South Wales
- School of Public Health, The University of Sydney, New South Wales
| | - Jonathan C. Craig
- College of Medicine and Public Health, Flinders University, South Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, New South Wales
| | - Sandra Banks
- Tharawal Aboriginal Corporation, New South Wales
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25
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Cullen P, Clapham K, Lo S, Rogers K, Hunter K, Treacy R, Porykali B, Keay L, Senserrick T, Ivers R. Communities driving change: evaluation of an Aboriginal driver licensing programme in Australia. Health Promot Int 2018; 33:925-937. [PMID: 29106515 DOI: 10.1093/heapro/dax036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The Driving Change programme was developed to facilitate access to licensing in Aboriginal communities in Australia. This process evaluation aimed to explore whether Driving Change was implemented as intended and was addressing the needs of the communities. A mixed methods approach was used, with triangulation of client data (n = 984), semi-structured interviews (n = 18) and client discussion groups (n = 21). Descriptive and regression analyses of quantitative and thematic analysis of qualitative data were drawn together to develop an integrated understanding of implementation barriers and facilitators. The programme reached 984 clients, with the majority from the target age group 16-24 years (56-89%). In multivariate analysis, clients who had supervised driving practice were 2.4 times more likely to attain a licence (95% CI: 1.9-3.1) and clients who received a high level of case management were 1.8 times more likely to progress to attain a licence than those who received low levels of case management (95% CI: 1.3-2.6). Implementation was facilitated by community partnerships and this was attributed to local delivery, Aboriginal leadership, connections with community networks and community ownership of solutions. Driving Change is engaging communities and reaching clients with a high level of need for licensing support. The programme is working with communities, benefiting from the input of cultural values and sharing ownership of local solutions. Community partnerships were critical to successfully supporting clients to overcome challenging barriers to participation. The learnings from this programme are relevant to complex community programme implementation and evaluation, particularly with diverse or hard to reach populations.
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Affiliation(s)
- Patricia Cullen
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.,School of Public Health, Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Serigne Lo
- Melanoma Institute Australia, Wolstencraft, Australia
| | - Kris Rogers
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Kate Hunter
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.,The Poche Centre for Indigenous Health, The University of Sydney, Camperdown, Australia
| | - Rebekah Treacy
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Bobby Porykali
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Lisa Keay
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Teresa Senserrick
- Transport and Road Safety Research, University of New South Wales, Sydney, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.,Flinders University, Adelaide, South Australia
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26
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Williamson A, Skinner A, Falster K, Clapham K, Eades SJ, Banks E. Mental health-related emergency department presentations and hospital admissions in a cohort of urban Aboriginal children and adolescents in New South Wales, Australia: findings from SEARCH. BMJ Open 2018; 8:e023544. [PMID: 30498044 PMCID: PMC6278810 DOI: 10.1136/bmjopen-2018-023544] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The aim of the current study is to quantify mental health-related emergency department (ED) presentations and hospitalisations, and associated child and family characteristics, in children recruited through four Aboriginal Community Controlled Health Organisations. SETTING Four Aboriginal Community Controlled Health Services that deliver primary care. All services were located in urban or large regional centres in New South Wales, Australia. PARTICIPANTS 1476 Aboriginal children aged 0-17 years at recruitment to the Study of Environment on Aboriginal Resilience and Child Health. PRIMARY OUTCOME MEASURES ED presentations and hospital admissions with a primary mental health diagnosis obtained via linkage to population health datasets. RESULTS Over a median of 6-year follow-up, there were 96 ED presentations affecting 62 children (10.7/1000 person-years) and 49 hospitalisations affecting 34 children (5.5/1000 person-years) for mental health conditions. Presentations/admissions increased with age. ED presentation was increased with: living in foster versus parental care (adjusted rate ratio (RR)=3.97, 95% CrI 1.26 to 11.80); high versus low baseline child emotional/behavioural problems (adjusted RR=2.93, 95% CrI 1.50 to 6.10); and caregiver chronic health conditions versus none (adjusted RR=2.81, 95% CrI 1.31 to 6.63). Hospitalisations were significantly increased with caregiver unemployment versus home duties (adjusted RR=4.48, 95% CrI 1.26 to 17.94) and caregiver chronic health problems versus none (adjusted RR=3.83, 95% CrI 1.33 to 12.12). CONCLUSIONS Tertiary care for mental health issues was relatively common among participating Aboriginal children, with risk elevated for those living in foster care, with prior mental health and behavioural problems and with carers with chronic illness and/or unemployment. While this study suggests high rates of serious mental health events among children from participating communities, the optimum means for reducing these rates, and the need for tertiary care, has not yet been determined. Such information is urgently required to inform policy and programmes to support Aboriginal child and adolescent mental health.
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Affiliation(s)
- Anna Williamson
- The Sax Institute, Sydney, NSW, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | | | - Kathleen Falster
- The Centre for Big Data Research in Health, University of New South Wales, Kensington, New South Wales, Australia
- The National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, Australia
| | - Sandra J Eades
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, Australian Capital Territory, Australia
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27
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Keay L, Hunter K, Ralph M, Porykali B, Lyford M, Clapham K, Lo W, Ivers R. Overcoming barriers to use of child car seats in an urban Aboriginal community-formative evaluation of a program for Aboriginal Community Controlled Health Services. Pilot Feasibility Stud 2018; 4:161. [PMID: 30377536 PMCID: PMC6195719 DOI: 10.1186/s40814-018-0351-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/02/2018] [Indexed: 11/10/2022] Open
Abstract
Background Little is known about the barriers to use of child car seats in Australian Aboriginal communities, or the acceptability of programs to increase appropriate car seat use. This formative evaluation sought to consult and partner with Aboriginal Community Controlled Health Services (ACCHS) to develop and evaluate the feasibility and acceptability of a program intended to improve optimal use of child car seats. Methods Focus groups were conducted with parents and carers of Aboriginal children to identify the barriers and facilitating factors for child car seat use, and staff of two ACCHS were interviewed to inform program development. Following the implementation of the resulting multi-faceted program, consisting of staff training, education, hands-on demonstrations and a subsidised car seat distribution scheme, interviews were conducted to assess process issues and acceptability with 13 staff members. Results Parents and carers in the focus groups reported a lack of awareness of child car seat use, confusion about the right car seats for different aged children but agreed about the importance of safety and community responsibility to keep children safe in cars. Interviews with service staff informed an approach to deliver relevant information. Information and resources were delivered to families, while the car seat distribution scheme supplied 33 families with child car seats. Following the conclusion of the program, staff reported that the program was relevant to their role. They also valued the car seat distribution scheme. Staff training in selection and installation of car seats increased confidence in staff knowledge. Conclusions We developed a program to promote child car seat use in ACCHS, which focused on developing capacity, made use of existing infrastructure and developed resources for use in this setting. The program shows promise as a means to promote child car seat use in Aboriginal communities; however, the impact on child car seat use will need to be evaluated in a larger scale prospective trial.
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Affiliation(s)
- Lisa Keay
- 1Injury Division, The George Institute for Global Health, University of New South Wales, Sydney, Level 5, 1 King Street Newtown, Sydney, 2042 Australia
| | - Kate Hunter
- 1Injury Division, The George Institute for Global Health, University of New South Wales, Sydney, Level 5, 1 King Street Newtown, Sydney, 2042 Australia.,2The Poche Centre for Indigenous Health, The University of Sydney, Room 224, Edward Ford Building (A27), Sydney, Australia
| | - Martyn Ralph
- 1Injury Division, The George Institute for Global Health, University of New South Wales, Sydney, Level 5, 1 King Street Newtown, Sydney, 2042 Australia
| | - Bobby Porykali
- 1Injury Division, The George Institute for Global Health, University of New South Wales, Sydney, Level 5, 1 King Street Newtown, Sydney, 2042 Australia
| | - Marilyn Lyford
- 3Cardiovascular Division, The George Institute for Global Health, University of New South Wales, Sydney, Level 5, 1 King Street Newtown, Sydney, 2042 Australia
| | - Kathleen Clapham
- 4Australian Health Services Research Institute, University of Wollongong, Building 234 (iC Enterprise 1) Innovation Campus, Wollongong, NSW 2522 Australia
| | - Winston Lo
- 5School of Public Health and Community Medicine, University of New South Wales, Sydney, Samuels Avenue, Kensington, Sydney, 2033 Australia
| | - Rebecca Ivers
- 1Injury Division, The George Institute for Global Health, University of New South Wales, Sydney, Level 5, 1 King Street Newtown, Sydney, 2042 Australia.,5School of Public Health and Community Medicine, University of New South Wales, Sydney, Samuels Avenue, Kensington, Sydney, 2033 Australia
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Clapham K, Bennett-Brook K, Hunter K. The role of Aboriginal family workers in delivering a child safety-focused home visiting program for Aboriginal families in an urban region of New South Wales. Health Promot J Austr 2018; 29:173-182. [PMID: 29742300 DOI: 10.1002/hpja.174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 04/27/2018] [Indexed: 11/08/2022] Open
Abstract
ISSUE ADDRESSED Aboriginal Australian children experience higher rates of injury than other Australian children. However, few culturally acceptable programs have been developed or evaluated. The Illawarra Aboriginal Medical Service (IAMS) developed the Safe Homes Safe Kids program as an injury prevention program targeting disadvantaged Aboriginal families with children aged 0-5 in an urban region of New South Wales. Delivered by Aboriginal Family Workers (AFWs), the program aims to reduce childhood injury by raising awareness of safety in the home. A program evaluation was conducted to determine the effectiveness of the home visiting model as an injury prevention program. This study reports on the qualitative interviews which explored the ways in which clients, IAMS staff and external service providers experienced the program and assessed its delivery by the AFWs. METHODS A qualitative program evaluation was conducted between January 2014 and June 2015. We report here on the semi-structured interviews undertaken with 34 individuals. RESULTS The results show increased client engagement in the program; improved child safety knowledge and skills; increased access to services; improved attitudes to home and community safety; and changes in the home safety environment. CONCLUSIONS Safe Homes Safe Kids provides a culturally appropriate child safety program delivered by AFWs to vulnerable families. Clients, IAMS staff and external service were satisfied with the family workers' delivery of the program and the holistic model of service provision. SO WHAT&QUEST This promising program could be replicated in other Aboriginal health services to address unintentional injury to vulnerable Aboriginal children.
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Affiliation(s)
- Kathleen Clapham
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, NSW, Australia
| | - Keziah Bennett-Brook
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, NSW, Australia
| | - Kate Hunter
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
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Young C, Craig JC, Clapham K, Williams S, Williamson A. Stressful life events and resilience among carers of Aboriginal children in urban New South Wales: cross-sectional findings from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). BMJ Open 2018; 8:e021687. [PMID: 29880570 PMCID: PMC6009629 DOI: 10.1136/bmjopen-2018-021687] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE In caregivers of urban Aboriginal children, to determine the frequency of major stressful life events, the proportion who meet criteria for resilience, and factors that are associated with resilience. DESIGN Cross-sectional survey. SETTING Four Aboriginal Community Controlled Health Services located in urban or regional areas in New South Wales, Australia. PARTICIPANTS 574 caregivers of Aboriginal children participating in the Study of Environment on Aboriginal Resilience and Child Health. PRIMARY OUTCOME MEASURE Resilience, defined as having experienced three or more stressful life events in the last 12 months, and having scores of ≤21 on the Kessler 10 Psychological Distress scale. RESULTS Over half (315, 55%) of the caregivers reported three or more stressful life events-the most common being a close family member who was hospitalised with a serious medical problem (259, 45%). Of the participants who experienced three or more stressful life events, almost three-quarters (227, 72%) met the criteria for resilience. Using multivariable analysis, two factors were independently associated with resilience: not having a physical health problem that limited normal activities (adjusted OR (aOR) 4.3; 95% CI 2.0 to 9.0), and not having problems caused by alcohol within the home (aOR 5.3; 95% CI 2.2 to 12.8). Having a child whose behaviour placed a great deal of burden on the family was associated with less resilience (aOR 0.25; 95% CI 0.09 to 0.68). CONCLUSIONS Caregivers of urban Aboriginal children experienced a large number of stressful events, the most common being the poor health of close family members, but most exhibited resilience. Resilience was associated with stable family environments and good physical health. The high number of stressful life events that caregivers experience is reflective of broader inequalities that Aboriginal communities face. The availability of easily accessible and long-term health and support services may go some way to reducing this inequality and improving social and emotional well-being for Aboriginal families.
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Affiliation(s)
- Christian Young
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia
| | - Jonathan C Craig
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, The University of Wollongong, Wollongong, New South Wales, Australia
| | - Sandra Williams
- Tharawal Aboriginal Corporation, Sydney, New South Wales, Australia
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Thurber K, Burgess L, Falster K, Banks E, Möller H, Ivers R, Cowell C, Isaac V, Kalucy D, Fernando P, Woodall C, Clapham K. Relation of child, caregiver, and environmental characteristics to childhood injury in an urban Aboriginal cohort in New South Wales, Australia. Aust N Z J Public Health 2017; 42:157-165. [DOI: 10.1111/1753-6405.12747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/01/2017] [Accepted: 10/01/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Katherine Thurber
- National Centre for Epidemiology and Population Health, Research School of Population Health; The Australian National University; Australian Capital Territory
| | - Leonie Burgess
- National Centre for Epidemiology and Population Health, Research School of Population Health; The Australian National University; Australian Capital Territory
- The Sax Institute; New South Wales
| | - Kathleen Falster
- National Centre for Epidemiology and Population Health, Research School of Population Health; The Australian National University; Australian Capital Territory
- The Sax Institute; New South Wales
- Centre for Big Data Research in Health; New South Wales
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health; The Australian National University; Australian Capital Territory
- The Sax Institute; New South Wales
| | - Holger Möller
- Centre for Big Data Research in Health; New South Wales
| | - Rebecca Ivers
- The George Institute for Global Health; UNSW Sydney; New South Wales
| | | | - Vivian Isaac
- Sydney Children's Health Network; New South Wales
| | | | | | | | - Kathleen Clapham
- Australian Health Services Research Institute; University of Wollongong; New South Wales
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31
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Möller H, Falster K, Ivers R, Clapham K, Harvey L, Jorm L. High rates of hospitalised burn injury in Indigenous children living in remote areas: a population data linkage study. Aust N Z J Public Health 2017; 42:108-109. [PMID: 29165893 DOI: 10.1111/1753-6405.12729] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Holger Möller
- Centre for Big Data Research in Health, UNSW, New South Wales.,Western Sydney Local Health District, Epidemiology and Health Analytics, New South Wales
| | - Kathleen Falster
- Centre for Big Data Research in Health, UNSW, New South Wales.,National Centre for Epidemiology and Population Health, The Australian National University, Australian Capital Territory.,The Sax Institute, New South Wales
| | - Rebecca Ivers
- The George Institute for Global Health, New South Wales
| | - Kathleen Clapham
- Australian Health Services Research Institute (AHSRI), University of Wollongong, New South Wales
| | - Lara Harvey
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, New South Wales.,University of New South Wales
| | - Louisa Jorm
- Centre for Big Data Research in Health, UNSW, New South Wales
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32
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Hunter K, Keay L, Clapham K, Brown J, Bilston LE, Lyford M, Gilbert C, Ivers RQ. "He's the Number One Thing in My World": Application of the PRECEDE-PROCEED Model to Explore Child Car Seat Use in a Regional Community in New South Wales. Int J Environ Res Public Health 2017; 14:ijerph14101206. [PMID: 28994725 PMCID: PMC5664707 DOI: 10.3390/ijerph14101206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 09/30/2017] [Accepted: 10/02/2017] [Indexed: 12/04/2022]
Abstract
We explored the factors influencing the use of age-appropriate car seats in a community with a high proportion of Aboriginal families in regional New South Wales. We conducted a survey and three focus groups with parents of children aged 3–5 years enrolled at three early learning centres on the Australian south-east coast. Survey data were triangulated with qualitative data from focus groups and analysed using the PRECEDE-PROCEED conceptual framework. Of the 133 eligible families, 97 (73%) parents completed the survey including 31% of parents who reported their children were Aboriginal. Use of age-appropriate car seats was reported by 80 (83%) of the participants, and awareness of the child car seat legislation was high (91/97, 94%). Children aged 2–3 years were less likely reported to be restrained in an age-appropriate car seat than were older children aged 4–5 years (60% versus 95%: χ2 = 19.14, p < 0.001). Focus group participants highlighted how important their child’s safety was to them, spoke of the influence grandparents had on their use of child car seats and voiced mixed views on the value of authorised child car seat fitters. Future programs should include access to affordable car seats and target community members as well as parents with clear, consistent messages highlighting the safety benefits of using age-appropriate car seats.
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Affiliation(s)
- Kate Hunter
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Lisa Keay
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Julie Brown
- Neuroscience Research Australia and University of New South Wales, NSW 2052, Sydney, Australia.
| | - Lynne E Bilston
- Neuroscience Research Australia and University of New South Wales, NSW 2052, Sydney, Australia.
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Marilyn Lyford
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Celeste Gilbert
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Rebecca Q Ivers
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
- Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia.
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Young C, Hanson C, Craig JC, Clapham K, Williamson A. Psychosocial factors associated with the mental health of indigenous children living in high income countries: a systematic review. Int J Equity Health 2017; 16:153. [PMID: 28830449 PMCID: PMC5568067 DOI: 10.1186/s12939-017-0652-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/15/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting. METHODS A systematic review of studies published between 1996 and 2016 that quantitatively evaluated the association between psychosocial variables and mental health among Indigenous children living in high income countries was conducted. Psychosocial variables were grouped into commonly occurring domains. Individual studies were judged to provide evidence for an association between a domain and either good mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence across all studies for each domain was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines. RESULTS Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4 [9%]), including 58,218 participants aged 4-20 years. Most papers were cross-sectional (39, 83%) and measured negative mental health outcomes (41, 87%). Children's negative cohesion with their families and the presence of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children's substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high self-esteem and optimism were associated with increased positive mental health outcomes. CONCLUSIONS Quantitative research investigating Indigenous children's mental health is largely cross-sectional and focused upon negative outcomes. Indigenous children living in high income countries share many of the same risk and protective factors associated with mental health. The evidence linking children's familial environment, psychological traits, substance use and experiences of discrimination with mental health outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental health of Indigenous children.
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Affiliation(s)
- Christian Young
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, Camperdown, NSW 2006 Australia
- Centre for Kidney Research, Westmead Institute for Medical Research, 179 Hawkesbury Rd, Westmead, NSW 2145 Australia
| | - Camilla Hanson
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, Camperdown, NSW 2006 Australia
- Centre for Kidney Research, Westmead Institute for Medical Research, 179 Hawkesbury Rd, Westmead, NSW 2145 Australia
| | - Jonathan C. Craig
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, Camperdown, NSW 2006 Australia
- Centre for Kidney Research, Westmead Institute for Medical Research, 179 Hawkesbury Rd, Westmead, NSW 2145 Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, Innovation Campus, University of Wollongong, Building 234 (iC Enterprise 1), Wollongong, NSW 2522 Australia
| | - Anna Williamson
- The Sax Institute, Level 13, Building 10, 235 Jones Street, Ultimo, NSW 2007 Australia
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Young C, Tong A, Nixon J, Fernando P, Kalucy D, Sherriff S, Clapham K, Craig JC, Williamson A. Perspectives on childhood resilience among the Aboriginal community: an interview study. Aust N Z J Public Health 2017; 41:405-410. [PMID: 28712160 DOI: 10.1111/1753-6405.12681] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/01/2017] [Accepted: 03/01/2017] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To describe Aboriginal community members' perspectives on the outcomes and origins of resilience among Aboriginal children. METHODS Face-to-face interviews were conducted with 36 Aboriginal adults (15 health service professionals, 8 youth workers and 13 community members) at two urban and one regional Aboriginal Community Controlled Health Service in New South Wales. Interviews were transcribed and analysed thematically. RESULTS We identified six themes: withstanding risk (displaying normative development, possessing inner fortitude); adapting to adversity (necessary endurance, masking inner vulnerabilities); positive social influences (secure family environments, role modelling healthy behaviours and relationships); instilling cultural identity (investing in Aboriginal knowledge, building a strong cultural self-concept); community safeguards (offering strategic sustainable services, holistic support, shared responsibility, providing enriching opportunities); and personal empowerment (awareness of positive pathways, developing self-respect, fostering positive decision making). CONCLUSIONS Community members believed that resilient Aboriginal children possessed knowledge and self-belief that encouraged positive decision making despite challenging circumstances. A strong sense of cultural identity and safe, stable and supportive family environments were thought to promote resilient behaviours. Implications for public health: Many Aboriginal children continue to face significant adversity. More sustainable, Aboriginal-led programs are needed to augment positive family dynamics, identify at-risk children and provide safeguards during periods of familial adversity.
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Affiliation(s)
- Christian Young
- Sydney School of Public Health, The University of Sydney, New South Wales.,Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, New South Wales.,Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales
| | | | | | | | - Simone Sherriff
- The Sax Institute, New South Wales.,Poche Centre for Indigenous Health, Sydney School of Public Health, The University of Sydney, New South Wales
| | - Kathleen Clapham
- Australian Health Services Research Institute, The University of Wollongong, New South Wales
| | - Jonathan C Craig
- Sydney School of Public Health, The University of Sydney, New South Wales.,Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales
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35
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Clapham K, Manning C, Williams K, O'Brien G, Sutherland M. Using a logic model to evaluate the Kids Together early education inclusion program for children with disabilities and additional needs. Eval Program Plann 2017; 61:96-105. [PMID: 27992780 DOI: 10.1016/j.evalprogplan.2016.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 11/28/2016] [Accepted: 12/07/2016] [Indexed: 06/06/2023]
Abstract
UNLABELLED Despite clear evidence that learning and social opportunities for children with disabilities and special needs are more effective in inclusive not segregated settings, there are few known effective inclusion programs available to children with disabilities, their families or teachers in the early years within Australia. The Kids Together program was developed to support children with disabilities/additional needs aged 0-8 years attending mainstream early learning environments. Using a key worker transdisciplinary team model, the program aligns with the individualised package approach of the National Disability Insurance Scheme (NDIS). AIM This paper reports on the use of a logic model to underpin the process, outcomes and impact evaluation of the Kids Together program. METHODS The research team worked across 15 Early Childhood Education and Care (ECEC) centres and in home and community settings. A realist evaluation using mixed methods was undertaken to understand what works, for whom and in what contexts. The development of a logic model provided a structured way to explore how the program was implemented and achieved short, medium and long term outcomes within a complex community setting. DISCUSSION AND CONCLUSION Kids Together was shown to be a highly effective and innovative model for supporting the inclusion of children with disabilities/additional needs in a range of environments central for early childhood learning and development. The use of a logic model provided a visual representation of the Kids Together model and its component parts and enabled a theory of change to be inferred, showing how a coordinated and collaborative approached can work across multiple environments.
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Affiliation(s)
- Kathleen Clapham
- University of Wollongong, Centre for Health Services Development (CHSD), Australian Health Services Research Institute (AHSRI), Wollongong, 2522, Australia.
| | - Claire Manning
- University of Wollongong, Centre for Health Services Development (CHSD), Australian Health Services Research Institute (AHSRI), Wollongong, 2522, Australia
| | - Kathryn Williams
- University of Wollongong, Centre for Health Services Development (CHSD), Australian Health Services Research Institute (AHSRI), Wollongong, 2522, Australia
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Clapham K, Hunter K, Cullen P, Helps Y, Senserrick T, Byrne J, Harrison JE, Ivers RQ. Addressing the barriers to driver licensing for Aboriginal people in New South Wales and South Australia. Aust N Z J Public Health 2017; 41:280-286. [PMID: 28245515 DOI: 10.1111/1753-6405.12654] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/01/2016] [Accepted: 11/01/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Low rates of driver licensing have been linked to increased risk of transport-related injury, and reduced access to health services, employment and educational opportunities in the Aboriginal population. This paper reports on how barriers to obtaining a driver licence are being addressed in four Aboriginal communities in New South Wales and South Australia. METHODS Qualitative data were collected over a four-month period in 2013. Interviews with Aboriginal and non-Aboriginal stakeholders (n=31) and 11 focus groups with Aboriginal participants (n=46) were analysed thematically using a framework approach. RESULTS Factors facilitating licensing included: family support, professional lessons, alternative testing and programs that assist with literacy, fines management, financial assistance and access to a supervising driver. Stakeholders recommended raising awareness of existing services and funding community-based service provision to promote access to licensing. DISCUSSION Facilitating licence participation requires systemic change and long-term investment to ensure interagency collaboration, service use and sustainability of relevant programs, including job search agencies. Implications for public health: The disadvantage faced by Aboriginal people in driver licensing is a fundamental barrier to participation and a social determinant of health. Understanding the factors that promote licensing is crucial to improving access for under-serviced populations; recommendations provide pragmatic solutions to address licensing disadvantage.
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Affiliation(s)
- Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, New South Wales
| | - Kate Hunter
- The George Institute for Global Health, University of Sydney, New South Wales.,The Poche Centre for Indigenous Health, University of Sydney, New South Wales
| | - Patricia Cullen
- The George Institute for Global Health, University of Sydney, New South Wales
| | | | - Teresa Senserrick
- Transport and Road Safety Research, University of New South Wales, New South Wales
| | - Jake Byrne
- The George Institute for Global Health, University of Sydney, New South Wales
| | | | - Rebecca Q Ivers
- The George Institute for Global Health, University of Sydney, New South Wales.,Flinders University, South Australia
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Möller H, Falster K, Ivers R, Falster MO, Clapham K, Jorm L. Closing the Aboriginal child injury gap: targets for injury prevention. Aust N Z J Public Health 2016; 41:8-14. [DOI: 10.1111/1753-6405.12591] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 05/01/2016] [Accepted: 06/01/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Holger Möller
- Centre for Big Data Research in Health; UNSW Kensington Campus; New South Wales
| | - Kathleen Falster
- Centre for Big Data Research in Health; UNSW Kensington Campus; New South Wales
- National Centre for Epidemiology and Population Health; The Australian National University; Australian Capital Territory
- The Sax Institute; New South Wales
| | - Rebecca Ivers
- The George Institute for Global Health; New South Wales
| | - Michael O. Falster
- Centre for Big Data Research in Health; UNSW Kensington Campus; New South Wales
| | - Kathleen Clapham
- The Australian Health Services Research Institute; University of Wollongong; New South Wales
| | - Louisa Jorm
- Centre for Big Data Research in Health; UNSW Kensington Campus; New South Wales
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Cullen P, Clapham K, Rogers K, Byrne J, Hunter K, Lo S, Ivers R. 57 Driving change: implementation of a multi-site community licensing program for aboriginal people. Inj Prev 2016. [DOI: 10.1136/injuryprev-2016-042156.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ivers RQ, Hunter K, Helps Y, Clapham K, Senserrick T, Byrne J, Martiniuk A, Daniels J, Harrison JE. 539 Driver licensing in aboriginal and torres strait islander people. Inj Prev 2016. [DOI: 10.1136/injuryprev-2016-042156.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Clapham K, Ivers R, Hunter K, Bennett-Brook K. 203 Addressing Australian Aboriginal child injury through policy and practice guidelines. Inj Prev 2016. [DOI: 10.1136/injuryprev-2016-042156.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Clapham K, Bennett-Brook K. 235 Evaluation of ‘Safe Home Safe Kids’: a home visiting program for Aboriginal Australian Children. Inj Prev 2016. [DOI: 10.1136/injuryprev-2016-042156.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hunter K, Keay L, Clapham K, Brown J, Bilston LE, Mannix S, Byrne J, Simpson JM, Ivers RQ. 58 Child car restraint use among aboriginal and torres strait islander children. Inj Prev 2016. [DOI: 10.1136/injuryprev-2016-042156.58] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cullen P, Clapham K, Hunter K, Treacy R, Ivers R. Challenges to driver licensing participation for Aboriginal people in Australia: a systematic review of the literature. Int J Equity Health 2016; 15:134. [PMID: 27581443 PMCID: PMC5007801 DOI: 10.1186/s12939-016-0422-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/16/2016] [Indexed: 11/25/2022] Open
Abstract
Introduction Aboriginal and Torres Strait Islander people are overrepresented in transport-related morbidity and mortality. Low rates of licensure in Aboriginal communities and households have been identified as a contributor to high rates of unlicensed driving. There is increasing recognition that Aboriginal people experience challenges and adversity in attaining a licence. This systematic review aims to identify the barriers to licence participation among Aboriginal people in Australia. Method A systematic search of electronic databases and purposive sampling of grey literature was conducted, two authors independently assessed publications for eligibility for inclusion. Results Twelve publications were included in this review, of which there were 11 reporting primary research (qualitative and mixed methods) and a practitioner report. Barriers identified were categorised as individual and family barriers or systemic barriers relating to the justice system, graduated driver licensing (GDL) and service provision. A model is presented that depicts the barriers within a cycle of licensing adversity. Discussion There is an endemic lack of licensing access for Aboriginal people that relates to financial hardship, unmet cultural needs and an inequitable system. This review recommends targeting change at the systemic level, including a review of proof of identification and fines enforcement policy, diversionary programs and increased provision for people experiencing financial hardship. Conclusion This review positions licensing within the context of barriers to social inclusion that Aboriginal people frequently encounter. Equitable access to licensing urgently requires policy reform and service provision that is inclusive, responsive to the cultural needs of Aboriginal people and accessible to regional and remote communities. Electronic supplementary material The online version of this article (doi:10.1186/s12939-016-0422-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patricia Cullen
- The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW, 2000, Australia. .,School of Public Health, Sydney Medical School, Edward Ford Building, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, Building 234, Innovation Campus, Wollongong, NSW, 2522, Australia
| | - Kate Hunter
- The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW, 2000, Australia.,School of Public Health, Sydney Medical School, Edward Ford Building, The University of Sydney, Sydney, NSW, 2006, Australia.,The Poche Centre for Indigenous Health, The University of Sydney, Edward Ford Building, Sydney, NSW, 2006, Australia
| | - Rebekah Treacy
- The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW, 2000, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW, 2000, Australia.,School of Public Health, Sydney Medical School, Edward Ford Building, The University of Sydney, Sydney, NSW, 2006, Australia
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Cullen P, Clapham K, Byrne J, Hunter K, Senserrick T, Keay L, Ivers R. The importance of context in logic model construction for a multi-site community-based Aboriginal driver licensing program. Eval Program Plann 2016; 57:8-15. [PMID: 27107303 DOI: 10.1016/j.evalprogplan.2016.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 01/14/2016] [Accepted: 03/07/2016] [Indexed: 06/05/2023]
Abstract
UNLABELLED Evidence indicates that Aboriginal people are underrepresented among driver licence holders in New South Wales, which has been attributed to licensing barriers for Aboriginal people. The Driving Change program was developed to provide culturally responsive licensing services that engage Aboriginal communities and build local capacity. AIM This paper outlines the formative evaluation of the program, including logic model construction and exploration of contextual factors. METHODS Purposive sampling was used to identify key informants (n=12) from a consultative committee of key stakeholders and program staff. Semi-structured interviews were transcribed and thematically analysed. Data from interviews informed development of the logic model. RESULTS Participants demonstrated high level of support for the program and reported that it filled an important gap. The program context revealed systemic barriers to licensing that were correspondingly targeted by specific program outputs in the logic model. Addressing underlying assumptions of the program involved managing local capacity and support to strengthen implementation. DISCUSSION This formative evaluation highlights the importance of exploring program context as a crucial first step in logic model construction. The consultation process assisted in clarifying program goals and ensuring that the program was responding to underlying systemic factors that contribute to inequitable licensing access for Aboriginal people.
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Affiliation(s)
- Patricia Cullen
- The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW 2000, Australia; School of Public Health, Sydney Medical School, The University of Sydney, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, The University of Wollongong, Australia
| | - Jake Byrne
- The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW 2000, Australia
| | - Kate Hunter
- The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW 2000, Australia; School of Public Health, Sydney Medical School, The University of Sydney, Australia; The Poche Centre for Indigenous Health, the University of Sydney, Australia
| | - Teresa Senserrick
- Transport and Road Safety Research, The University of New South Wales, Australia
| | - Lisa Keay
- The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW 2000, Australia; School of Public Health, Sydney Medical School, The University of Sydney, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, Level 3, 50 Bridge Street, Sydney, NSW 2000, Australia; School of Public Health, Sydney Medical School, The University of Sydney, Australia.
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Williamson A, D'Este C, Clapham K, Redman S, Manton T, Eades S, Schuster L, Raphael B. What are the factors associated with good mental health among Aboriginal children in urban New South Wales, Australia? Phase I findings from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). BMJ Open 2016; 6:e011182. [PMID: 27381207 PMCID: PMC4947800 DOI: 10.1136/bmjopen-2016-011182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To identify the factors associated with 'good' mental health among Aboriginal children living in urban communities in New South Wales, Australia. DESIGN Cross-sectional survey (phase I of a longitudinal study). SETTING 4 Aboriginal Community Controlled Health Services that deliver primary care. All services were located in urban communities in New South Wales, Australia. PARTICIPANTS 1005 Aboriginal children aged 4-17 years who participated in phase I of the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). PRIMARY OUTCOME MEASURE Carer report version of the Strengths and Difficulties Questionnaire. Scores <17 were considered to indicate 'good' mental health for the purposes of this article. RESULTS The majority (72%) of SEARCH participants were not at high risk for emotional or behavioural problems. After adjusting for the relative contributions of significant demographic, child and carer health factors, the factors associated with good mental health among SEARCH children were having a carer who was not highly psychologically distressed (OR=2.8, 95% CI 1.6 to 5.1); not suffering from frequent chest, gastrointestinal or skin infections (OR=2.8, 95% CI 1.8 to 4.3); and eating two or more servings of vegetables per day (OR=2.1, 95% CI 1.2 to 3.8). Being raised by a foster carer (OR=0.2, 95% CI 0.01 to 0.71) and having lived in 4 or more homes since birth (OR=0.62, 95% CI 0.39 to 1.0) were associated with significantly lower odds of good mental health. Slightly different patterns of results were noted for adolescents than younger children. CONCLUSIONS Most children who participated in SEARCH were not at high risk for emotional or behavioural problems. Promising targets for efforts to promote mental health among urban Aboriginal children may include the timely provision of medical care for children and provision of additional support for parents and carers experiencing mental or physical health problems, for adolescent boys and for young people in the foster care system.
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Affiliation(s)
- Anna Williamson
- School of Public Health and Community Medicine, University of New South Wales, Kensington, New South Wales, Australia
- The Sax Institute, Haymarket, New South Wales, Australia
| | - Catherine D'Este
- National Centre for Epidemiology and Community Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, Australia
| | - Sally Redman
- The Sax Institute, Haymarket, New South Wales, Australia
| | - Toni Manton
- Awabakal Aboriginal Medical Service, Hamilton, New South Wales, Australia
| | - Sandra Eades
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Leanne Schuster
- Aboriginal Medical Service Western Sydney, Mount Druitt Village, New South Wales, Australia
| | - Beverley Raphael
- School of Medicine, University of Western Sydney, Penrith South, New South Wales, Australia
- Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
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Ivers RQ, Hunter K, Clapham K, Helps Y, Senserrick T, Byrne J, Martiniuk A, Daniels J, Harrison JE. Driver licensing: descriptive epidemiology of a social determinant of Aboriginal and Torres Strait Islander health. Aust N Z J Public Health 2016; 40:377-82. [PMID: 27481274 PMCID: PMC5084803 DOI: 10.1111/1753-6405.12535] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 10/01/2015] [Accepted: 01/01/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Education, employment and equitable access to services are commonly accepted as important underlying social determinants of health. For most Australians, access to health, education and other services is facilitated by private transport and a driver licence. This study aimed to examine licensing rates and predictors of licensing in a sample of Aboriginal and Torres Strait Islander people, as these have previously been poorly described. METHODS Interviewer-administered surveys were conducted with 625 people 16 years or older in four Aboriginal Community Controlled Health Services in New South Wales and South Australia over a two-week period in 2012-2013. RESULTS Licensing rates varied from 51% to 77% by site. Compared to not having a licence, having a driver licence was significantly associated with higher odds of full-time employment (adjusted OR 4.0, 95%CI 2.5-6.3) and educational attainment (adjusted OR 1.9, 95%CI 1.2-2.8 for trade or certificate; adjusted OR 4.0, 95%CI 1.6-9.5 for degree qualification). CONCLUSIONS Variation in driver licensing rates suggests different yet pervasive barriers to access. There is a strong association between driver licensing, education and employment. IMPLICATIONS Licensing inequality has far-reaching impacts on the broader health and wellbeing of Aboriginal and Torres Strait Islander people, reinforcing the need for appropriate and accessible pathways to achieving and maintaining driver licensing.
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Affiliation(s)
- Rebecca Q Ivers
- The George Institute for Global Health, The University of Sydney, New South Wales.,Flinders University, South Australia
| | - Kate Hunter
- The George Institute for Global Health, The University of Sydney, New South Wales.,The Poche Centre for Indigenous Health, University of Western Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, New South Wales
| | | | - Teresa Senserrick
- Transport and Road Safety Research, The University of New South Wales
| | - Jake Byrne
- The George Institute for Global Health, The University of Sydney, New South Wales
| | - Alexandra Martiniuk
- The George Institute for Global Health, The University of Sydney, New South Wales.,Sydney Medical School, The University of Sydney, New South Wales
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Cullen P, Clapham K, Byrne J, Hunter K, Rogers K, Senserrick T, Keay L, Ivers R. Implementation of a driver licensing support program in three Aboriginal communities: a brief report from a pilot program. Health Promot J Austr 2016; 27:167-169. [PMID: 27071956 DOI: 10.1071/he15089] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 01/08/2016] [Indexed: 11/23/2022] Open
Abstract
Issue addressed: Aboriginal people face significant barriers to accessing the driver licensing system in New South Wales (NSW). Low rates of licence participation contribute to transport disadvantage and impede access to employment, education and essential health services. The Driving Change program has been piloted in three communities to increase licensing rates for young Aboriginal people. This brief report reviews implementation to determine whether Driving Change is being delivered as intended to the target population.Methods: Descriptive analysis of routinely collected program data collected between April 2013 and October 2014 to monitor client demographics (n = 194) and program-specific outcomes.Results: The target population is being reached with the majority of clients aged 16-24 years (76%) and being unemployed (53%). Licensing outcomes are being achieved at all pilot sites (learner licence 19%; provisional or unrestricted licence 16%). There is variation in program delivery across the three pilot sites demonstrating the intended flexibility of the program.Conclusions: Driving Change is delivering all aspects of the program as intended at the three pilot sites. The program is reaching the target population and providing a sufficiently flexible program that responds to community and client identified need.So what?: Reviewing implementation of community pilot programs is critical to ensure that the intervention is being delivered as intended to the target population. This brief report indicates that Driving Change is assisting young Aboriginal people to access licensing services in NSW. This review of program implementation will assist the subsequent expansion of the program to a further nine communities in NSW.
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Affiliation(s)
- Patricia Cullen
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Level 3, Bridge Street, Sydney, NSW 2000, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, Building 234, Innovation Campus, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Jake Byrne
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Level 3, Bridge Street, Sydney, NSW 2000, Australia
| | - Kate Hunter
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Level 3, Bridge Street, Sydney, NSW 2000, Australia
| | - Kris Rogers
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Level 3, Bridge Street, Sydney, NSW 2000, Australia
| | - Teresa Senserrick
- Transport and Road Safety Research, Level 1, West Wing, Old Main Building, University of New South Wales, NSW 2052, Australia
| | - Lisa Keay
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Level 3, Bridge Street, Sydney, NSW 2000, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Level 3, Bridge Street, Sydney, NSW 2000, Australia
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Möller H, Falster K, Ivers R, Falster M, Randall D, Clapham K, Jorm L. Inequalities in Hospitalized Unintentional Injury Between Aboriginal and Non-Aboriginal Children in New South Wales, Australia. Am J Public Health 2016; 106:899-905. [PMID: 26890169 DOI: 10.2105/ajph.2015.303022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To quantify inequalities in rates of unintentional injury-related hospitalizations between Australian Aboriginal and non-Aboriginal children. METHODS We used linked hospital and mortality data to construct a retrospective whole-of-population birth cohort including 1,124,717 children born in the state of New South Wales, Australia, between July 1, 2000 and December 31, 2012. We adjusted hazard ratios (HRs) of first injury hospitalization for geographic clustering and individual- and area-level factors. RESULTS Aboriginal children were 1.6 times more likely than were non-Aboriginal children to be hospitalized for an unintentional injury. The largest inequalities were for poisoning (HR = 2.7; 95% CI = 2.4, 3.0) and injuries stemming from exposure to fire, flames, heat, and hot substances (HR = 2.4; 95% CI = 2.1, 2.7). Adjustment reduced the inequality for all unintentional injury overall (HR = 1.4; 95% CI = 1.3, 1.4) and within leading injury mechanisms. CONCLUSIONS Australian Aboriginal children suffer a disproportionately high burden of unintentional injury.
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Affiliation(s)
- Holger Möller
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Kathleen Falster
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Rebecca Ivers
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Michael Falster
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Deborah Randall
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Kathleen Clapham
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Louisa Jorm
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
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Ivers RQ, Hunter K, Clapham K, Coombes J, Fraser S, Lo S, Gabbe B, Hendrie D, Read D, Kimble R, Sparnon A, Stockton K, Simpson R, Quinn L, Towers K, Potokar T, Mackean T, Grant J, Lyons RA, Jones L, Eades S, Daniels J, Holland AJA. Understanding burn injuries in Aboriginal and Torres Strait Islander children: protocol for a prospective cohort study. BMJ Open 2015; 5:e009826. [PMID: 26463225 PMCID: PMC4606434 DOI: 10.1136/bmjopen-2015-009826] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Although Aboriginal and Torres Strait Islander children in Australia have higher risk of burns compared with non-Aboriginal children, their access to burn care, particularly postdischarge care, is poorly understood, including the impact of care on functional outcomes. The objective of this study is to describe the burden of burns, access to care and functional outcomes in Aboriginal and Torres Strait Islander children in Australia, and develop appropriate models of care. METHODS AND ANALYSIS All Aboriginal and Torres Strait Islander children aged under 16 years of age (and their families) presenting with a burn to a tertiary paediatric burn unit in 4 Australian States (New South Wales (NSW), Queensland, Northern Territory (NT), South Australia (SA)) will be invited to participate. Participants and carers will complete a baseline questionnaire; follow-ups will be completed at 3, 6, 12 and 24 months. Data collected will include sociodemographic information; out of pocket costs; functional outcome; and measures of pain, itch and scarring. Health-related quality of life will be measured using the PedsQL, and impact of injury using the family impact scale. Clinical data and treatment will also be recorded. Around 225 participants will be recruited allowing complete data on around 130 children. Qualitative data collected by in-depth interviews with families, healthcare providers and policymakers will explore the impact of burn injury and outcomes on family life, needs of patients and barriers to healthcare; interviews with families will be conducted by experienced Aboriginal research staff using Indigenous methodologies. Health systems mapping will describe the provision of care. ETHICS AND DISSEMINATION The study has been approved by ethics committees in NSW, SA, NT and Queensland. Study results will be distributed to community members by study newsletters, meetings and via the website; to policymakers and clinicians via policy fora, presentations and publication in peer-reviewed journals.
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Affiliation(s)
- Rebecca Q Ivers
- Injury Division, The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia School of Midwifery and Nursing, Flinders University, Adelaide, South Australia, Australia
| | - Kate Hunter
- Injury Division, The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia Poche Centre for Indigenous Health, University of Sydney, Sydney, New South Wales, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Julieann Coombes
- Injury Division, The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Fraser
- School of Midwifery and Nursing, Flinders University, Adelaide, South Australia, Australia
| | - Serigne Lo
- Injury Division, The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Belinda Gabbe
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Delia Hendrie
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - David Read
- National Critical Care & Trauma Response Centre, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Roy Kimble
- Australian Centre for Children's Burns and Trauma Research, University of Queensland, Brisbane, Queensland, Australia
| | - Anthony Sparnon
- Paediatric Burn Unit, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Kellie Stockton
- Australian Centre for Children's Burns and Trauma Research, University of Queensland, Brisbane, Queensland, Australia
| | - Renee Simpson
- National Critical Care & Trauma Response Centre, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Linda Quinn
- Paediatric Burn Unit, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Kurt Towers
- Aboriginal Health, Northern and Central Adelaide Local Health Networks, Adelaide, South Australia, Australia
| | - Tom Potokar
- Department of Burns & Plastic Surgery, Welsh Centre for Burns & Plastic Surgery, Swansea, UK
| | - Tamara Mackean
- Poche Centre for Indigenous Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia
| | - Julian Grant
- School of Midwifery and Nursing, Flinders University, Adelaide, South Australia, Australia
| | - Ronan A Lyons
- Farr Institute, Swansea University Medical School, Wales, UK
| | - Lindsey Jones
- Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Sandra Eades
- Department of Aboriginal Health, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - John Daniels
- Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Andrew J A Holland
- Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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Hunter K, Keay L, Clapham K, Lyford M, Brown J, Bilston L, Simpson JM, Stevenson M, Ivers RQ. Buckle up safely (shoalhaven): a process and impact evaluation of a pragmatic, multifaceted preschool-based pilot program to increase correct use of age-appropriate child restraints. Traffic Inj Prev 2014; 15:483-490. [PMID: 24678571 DOI: 10.1080/15389588.2013.833328] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To conduct a process and impact evaluation of a multifaceted education-based pilot program targeting correct use of age-appropriate restraints in a regional setting with a high proportion of Aboriginal and Torres Strait Islander families. METHODS The program was delivered in 2010 in 3 early learning centers where 31 percent of the children were of Aboriginal and Torres Strait Islander descent. Each component of the program was assessed for message consistency and uptake. To measure program effectiveness, participating children were matched 1:1 by age, language spoken at home, and annual household income with 71 children from the control arm of a contemporaneous trial. The outcome measure in the control and program centers (a 4-category ordinal scale of restraint use) was compared using ordinal logistic regression accounting for age of the parent. RESULTS Process evaluation found that though program components were delivered with a consistency of message, uptake was affected by turnover of all staff at one center and by parents experiencing difficulty in paying for subsidized restraints at each of the centers. Impact evaluation found that children from the centers receiving the program had nearly twice the odds of being in a better restraint category than children matched from the control group (adjusted odds ratio [ORadj] = 2.06, 95% confidence interval [CI], 1.09-3.90). CONCLUSIONS This was a pragmatic study reflecting the real-life issues of implementing a program in preschools where 57 percent of families had a low income and turnover of staff was high. Despite these issues, impact evaluation showed that the integrated educational program showed promise in increasing correct use of age-appropriate restraints. The findings from this pilot study support the use of an integrated educational program that includes access to subsidized restraints to promote best practice child restraint use among communities that include a high proportion of Aboriginal and Torres Strait Islander families in New South Wales. Future trials in similar settings should consider offering more support in centers with high turnover of staff and offering alternative methods of payment when families experience financial difficulties in purchasing the subsidized restraints. If proven in larger trials, this approach could reduce death and injuries in child passengers in this vulnerable group.
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Affiliation(s)
- Kate Hunter
- a The George Institute for Global Health , Sydney , New South Wales , Australia
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