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Drew N, McAllister M, Coffin J, Robinson M, Katzenellenbogen J, Armstrong E. Corrigendum to: Healing Right Way randomised control trial enhancing rehabilitation services for Aboriginal people with brain injury in Western Australia: translation principles and activities. BRAIN IMPAIR 2024; 25:IB23109_CO. [PMID: 38739737 DOI: 10.1071/ib23109_co] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
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Drew N, McAllister M, Coffin J, Robinson M, Katzenellenbogen J, Armstrong E. Healing Right Way randomised control trial enhancing rehabilitation services for Aboriginal people with brain injury in Western Australia: translation principles and activities. BRAIN IMPAIR 2024; 25:IB23109. [PMID: 38640359 DOI: 10.1071/ib23109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/21/2024] [Indexed: 04/21/2024]
Abstract
Background This report provides the theory, method and practice of culturally secure translation and knowledge exchange in the Healing Right Way Clinical Trial (2017-2022), outlining activities to date. Healing Right Way was a stepped wedge cluster randomised controlled trial conducted in Western Australia, aimed at enhancing rehabilitation services and quality of life for Aboriginal Australians following acquired brain injury. The trial translation plan was aspirational and action-oriented, with its implementation iterative and ongoing. Translational activities aimed to inform service and research planning for Aboriginal people with brain injury. Situated in the intercultural space, the work guards against undertaking activities that are monocultural, colonial and appropriating in favour of work that is authentically viewed through the dual lens of whiteness and Aboriginal and Torres Strait Islander ways of knowing, being and doing, and is strengths-based. Methods Three translational and knowledge exchange components were identified, relating to the role of Aboriginal Brain Injury Coordinators, cultural training of hospital staff and the research process itself. Knowledge plans were developed for key audiences, with potential translation products to be monitored for ongoing impact. Results Results demonstrate that translational and knowledge exchange were iteratively embedded throughout the trial life cycle. Data sources included community engagement, partnership meetings and interviews. Activities involved presentations to diverse audiences including bureaucrats, community and participants. Conclusions This report provides a snapshot of the first translation knowledge exchange plan and activities constructed in relation to brain injury rehabilitation services for Aboriginal people. Challenges encountered, as well as successes to date, are discussed.
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Affiliation(s)
- Neil Drew
- Kurongkurl Katitjin, Edith Cowan University, Perth, WA, Australia
| | - Meaghan McAllister
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Juli Coffin
- Ngangk Yira Institute for Change, Murdoch University, Broome, WA, Australia
| | - Melanie Robinson
- Ngangk Yira Institute for Change, Murdoch University, Broome, WA, Australia
| | - Judith Katzenellenbogen
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Elizabeth Armstrong
- University Department of Rural Health South West, Edith Cowan University, Bunbury, Australia
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Armstrong E, Colegate K, Papertalk L, Crowe S, McAllister M, Hersh D, Ciccone N, Godecke E, Katzenellenbogen J, Coffin J. Intersectionality and Its Relevance in the Context of Aboriginal People with Brain Injury in Australia. Semin Speech Lang 2024; 45:56-70. [PMID: 37992734 DOI: 10.1055/s-0043-1776755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
In this article, we explore the benefits of recognizing the impact of intersectionality on access to, and provision of, brain injury care in a First Nations context. While disadvantage and discrimination are often associated with the intersection of culture, gender, disability, and socioeconomic disadvantage, it is only when these factors are explored together that clinicians can really understand what people need to recover and thrive following acquired brain injury. In this article, we challenge speech-language pathologists to examine their own practices, to look beyond Western models of health and constraints of many current institutional models of care and ways of framing research, to acknowledge historical and ongoing colonizing influences, and to engage with community-led solutions. We provide a model of Aboriginal-led care, where intersection of discrimination and marginalization is minimized and the multiple components of the individual, carers/communication partners, and the environment become empowering factors instead.
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Affiliation(s)
- Elizabeth Armstrong
- University Department of Rural Health, Edith Cowan University, Bunbury, Western Australia, Australia
| | - Kerri Colegate
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Lenny Papertalk
- WA Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia
| | - Stuart Crowe
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Meaghan McAllister
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Deborah Hersh
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Natalie Ciccone
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Judith Katzenellenbogen
- Cardiovascular Epidemiology Research Centre, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Juli Coffin
- Ngangk Yira Institute for Change, Murdoch University, Broome, Western Australia, Australia
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McRae T, Walker R, Enkel S, Thomas HMM, Jacky J, Sibosado S, Mullane M, Maginnis N, Coffin J, Carapetis JR, Bowen AC. HipHop2SToP a community-led health promotion initiative empowering Aboriginal youth in the Kimberley region of Western Australia: a process evaluation. Front Public Health 2023; 11:1258517. [PMID: 38145075 PMCID: PMC10740280 DOI: 10.3389/fpubh.2023.1258517] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/08/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction For millennia, Aboriginal people's ways of knowing, doing and being were shared through art, song, and dance. Colonisation silenced these ways, affecting loss of self-determination for Aboriginal people. Over the past decade in Australia, hip-hop projects have become culturally appropriate approaches for health promotion. When community led, and Aboriginal worldviews centralised, hip-hop workshops are more likely to be effective. In 2020, during the COVID-19 pandemic, a community-led health promotion hip-hop music video, 'HipHop2SToP' was produced involving young people in Dampier Peninsula communities address healthy skin and healthy living practices. Methods We report here a qualitative process evaluation of the HipHop2SToP project. Participants who had been involved in the planning and production of HipHop2SToP were selected using a purposive approach and invited either by email or face-to-face to participate in semi-structured interviews and share their experiences. Semi-structured interviews ranged from 30 to 60 min in duration and were conducted either face-to-face or virtually over MS Teams. Due to personal time constraints, two participants provided written responses to the semi-structured questions. All interviews were audio-recorded with consent and saved as a digital recording in a de-identified format. All audio recordings were transcribed verbatim and uploaded into QSR NVivo v12 along with written responses. Results As a health promotion project, the critical success factors were community-ownership and discovering novel ways to collaborate virtually with remote communities using Microsoft (MS) software. Highlights included observing the young people actively engaged in the project and their catchy lyrics and key messaging for environmental health and skin infections. COVID-19 presented some challenges. Gaps in communication, clarification of stakeholder roles and expectations, and post-production outcomes were also identified as challenges. Conclusion HipHop2SToP validates the need for Aboriginal community led health promotion programs. While creating some challenges COVID-19 also strengthened community ownership and created novel ways of maintaining relationships with remote Aboriginal communities. Future hip-hop projects would benefit from clarity of roles and responsibilities. Strengthening post-production outcomes by including a launch and well-planned, targeted communication and dissemination strategy will ensure the wider translation of important health messages and potential strengthen sustainability.
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Affiliation(s)
- Tracy McRae
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
| | - Roz Walker
- Ngangk Yira Institute For Change, Murdoch University, Perth, WA, Australia
- School of Indigenous Studies, Poche Centre for Indigenous Health Research, University of Western Australia, Perth, WA, Australia
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Stephanie Enkel
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
| | - Hannah M. M. Thomas
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
| | - John Jacky
- Telethon Kids Institute, Nedlands, WA, Australia
| | | | - Marianne Mullane
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
| | | | - Juli Coffin
- Ngangk Yira Institute For Change, Murdoch University, Perth, WA, Australia
| | - Jonathan R. Carapetis
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
- Department of Infectious Diseases, Perth Children’s Hospital, Nedlands, WA, Australia
| | - Asha C. Bowen
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Department of Infectious Diseases, Perth Children’s Hospital, Nedlands, WA, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- University of Notre Dame, Fremantle, WA, Australia
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Lin I, Flanagan W, Green C, Lowell A, Coffin J, Bessarab D. Clinical yarning education: development and pilot evaluation of an education program to improve clinical communication in Aboriginal health care - participant, and health manager perspectives. BMC Med Educ 2023; 23:908. [PMID: 38036987 PMCID: PMC10688002 DOI: 10.1186/s12909-023-04843-8] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Effective communication between health care clinicians and Aboriginal patients is critical to delivering high quality, accessible, culturally secure health care. Despite this, ineffective communication is a well-documented barrier, and few studies have reported interventions to improve communication. Clinical Yarning is a patient centred communication framework for Aboriginal health care. Building on this framework, this study reports the development and evaluation of a Clinical Yarning education program. METHODS A Clinical Yarning education program was developed, underpinned by the principles of cultural security and adult learning, informed by a behavioural skills approach. The program was delivered in five health/education settings in one rural Western Australian region. Mixed-methods evaluation included a retrospective pre/post questionnaire to ascertain changes in participants' knowledge, confidence, competence and their perceptions about communication in Aboriginal health care, and the program. Qualitative semi-structured interviews were undertaken with health service managers who oversaw each health care setting and who had not participated in the education program, to explore perceptions about the program and implementation considerations. RESULTS Twenty-eight health care clinicians and six students completed training and the evaluation survey. There were significant improvements in self-rated communication skills, ability, confidence, knowledge, and perceived importance of communication training from pre to post-program. Participants strongly recommended the program to others, and most commonly valued the simulation/interactive learning activities. Health service managers acknowledged the limitations in most existing cultural training, and felt Clinical Yarning addressed a need; both the concept of Clinical Yarning and the education program provided were valued. Considerations identified for future implementation included: building multilevel partnerships within health services, offering alternate training options such as eLearning or train-the-trainer approaches, and integrating into existing development programs. Workforce transiency and availability were a barrier, particularly in remote areas. CONCLUSIONS This study offers preliminary support for the Clinical Yarning education program and provides a foundation for further development of this training approach. A future priority is implementation research to investigate the impact of the Clinical Yarning education program on health care and patient outcomes.
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Affiliation(s)
- Ivan Lin
- Western Australian Centre for Rural Health, University of Western Australia, Fitzgerald St, Geraldton, WA, 6531, Australia.
| | - Wanda Flanagan
- Western Australian Centre for Rural Health, University of Western Australia, Fitzgerald St, Geraldton, WA, 6531, Australia
| | - Charmaine Green
- Western Australian Centre for Rural Health, University of Western Australia, Fitzgerald St, Geraldton, WA, 6531, Australia
| | - Anne Lowell
- Research Centre for Health and Wellbeing, Charles Darwin University, Ellengowan Drive, Brinkin, Darwin, NT, 0909, Australia
| | - Juli Coffin
- Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, 6150, Australia
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, University of Western Australia, Stirling Highway, Crawley, WA, 6009, Australia
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McRae T, Leaversuch F, Sibosado S, Coffin J, Carapetis JR, Walker R, Bowen AC. Culturally supported health promotion to See, Treat, Prevent (SToP) skin infections in Aboriginal children living in the Kimberley region of Western Australia: a qualitative analysis. Lancet Reg Health West Pac 2023; 35:100757. [PMID: 37424680 PMCID: PMC10326714 DOI: 10.1016/j.lanwpc.2023.100757] [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] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 07/11/2023]
Abstract
Background While there are many skin infections, reducing the burden of scabies and impetigo for remote living Aboriginal people, particularly children remains challenging. Aboriginal children living in remote communities have experienced the highest reported rate of impetigo in the world and are 15 times more likely to be admitted to hospital with a skin infection compared to non-Aboriginal children. Untreated impetigo can develop into serious disease and may contribute to the development of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). As the largest organ protecting the body and visible to everyone, skin infections are often unsightly and very painful, therefore maintaining healthy skin and reducing the burden of skin infections is important for overall physical and cultural health and well-being. Biomedical treatments alone will not address these factors; therefore, a holistic, strengths-based approach that aligns with the Aboriginal world view of wellness is required to help reduce the prevalence of skin infections and their downstream consequences. Methods Culturally appropriate yarning sessions with community members were conducted between May 2019 and November 2020. Yarning sessions have been identified as a valid method for story sharing and collecting information. Semi-structured, face-to-face interviews and focus groups with school and clinic staff were conducted. When consent was provided, interviews were audio-recorded and saved as a digital recording in a de-identified format; for those yarning sessions not recorded, handwritten notes were scribed. Audio recordings and handwritten notes were uploaded into NVivo software prior to a thematic analysis being conducted. Findings Overall, there was a strong knowledge of recognition, treatment, and prevention of skin infections. However, this did not extend to the role skin infections play in causing ARF, RHD or kidney failure. Our study has confirmed three main findings: 1. The biomedical model of treatment of skin infections remained strong in interviews with staff living in the communities; 2. Community members have a reliance and belief in traditional remedies for skin infections; and 3. Ongoing education for skin infections using culturally appropriate health promotion resources. Interpretation While this study revealed ongoing challenges with service practices and protocols associated with treating and preventing skin infections in a remote setting, it also provides unique insights requiring further investigation. Bush medicines are not currently practiced in a clinic setting, however, using traditional medicines alongside biomedical treatment procedures facilitates cultural security for Aboriginal people. Further investigation, and advocacy to establish these into practice, procedures and protocols is warranted. Establishing protocols and practice procedures focused on improving collaborations between service providers and community members in remote communities is also recommended. Funding Funding was received from the National Health and Medical Research Council [NHMRC] (GNT1128950), Health Outcomes in the Tropical NORTH [HOT NORTH 113932] (Indigenous Capacity Building Grant), and WA Health Department and Healthway grants contributed to this research. A.C.B. receives a NHMRC investigator Award (GNT1175509). T.M. receives a PhD scholarship from the Australian Centre for Elimination of Neglected Tropical Diseases (ACE-NTD), an NHMRC centre of excellence (APP1153727).
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Affiliation(s)
- Tracy McRae
- University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
- Telethon Kids Institute, 15 Hospital Road, Nedlands, Western Australia 6009, Australia
| | | | - Slade Sibosado
- Telethon Kids Institute, 15 Hospital Road, Nedlands, Western Australia 6009, Australia
| | - Juli Coffin
- University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
- Ngangk Yira Institute for Change, Murdoch University, 90 South St, Murdoch, Western Australia 6150, Australia
| | - Jonathan R. Carapetis
- University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
- Telethon Kids Institute, 15 Hospital Road, Nedlands, Western Australia 6009, Australia
- Perth Children's Hospital, 15 Hospital Road, Nedlands, Western Australia, 6009, Australia
| | - Roz Walker
- Ngangk Yira Institute for Change, Murdoch University, 90 South St, Murdoch, Western Australia 6150, Australia
- School of Indigenous Studies, Poche Centre for Indigenous Health Research, University of Western Australia, 35 Stirling Highway, Perth, Australia
- School of Population and Global Health, University of Western Australia, 35 Stirling Highway, Perth, Australia
| | - Asha C. Bowen
- University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
- Telethon Kids Institute, 15 Hospital Road, Nedlands, Western Australia 6009, Australia
- Perth Children's Hospital, 15 Hospital Road, Nedlands, Western Australia, 6009, Australia
- Menzies School of Health Research, Rocklands Drive, Tiwi, Northern Territory 0810, Australia
- University of Notre Dame, 32 Mouat St, Fremantle, Western Australia 6160, Australia
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Armstrong E, Mcallister M, Coffin J, Robinson M, Thompson S, Katzenellenbogen J, Colegate K, Papertalk L, Hersh D, Ciccone N, White J. Communication services for First Nations peoples after stroke and traumatic brain injury: Alignment of Sustainable Development Goals 3, 16 and 17. Int J Speech Lang Pathol 2023; 25:147-151. [PMID: 36412124 DOI: 10.1080/17549507.2022.2145356] [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] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
PURPOSE Colonisation and continuing discrimination have significantly and negatively impacted the physical, social and emotional wellbeing of First Nations peoples globally. In Australia, Aboriginal cultures thrive despite ongoing barriers to health care. This paper describes challenges and new initiatives for Australian Aboriginal people with acquired communication disability after brain injury and their alignment with the global aims forming the Sustainable Development Goals. RESULT Research undertaken by an Aboriginal and non-Aboriginal multidisciplinary team over a decade in Western Australia identified and responded to mismatches between community needs and services. Initiatives described include the Missing Voices, Healing Right Way, Brain Injury Yarning Circles and Wangi/Yarning Together projects. Recommendations implemented related to (a) greater incorporation of Aboriginal cultural protocols and values within services, (b) more culturally secure assessment and treatment tools, (c) support after hospital discharge, (d) Aboriginal health worker involvement in support. Implementation includes cultural training of hospital staff, trialling new assessment and treatment methods, and establishing community-based Aboriginal Brain Injury Coordinator positions and relevant peer support groups. CONCLUSION Culturally secure brain injury rehabilitation in Australia is in its infancy. Our initiatives challenge assumptions about worldviews and established Western biomedical models of healthcare through incorporating Indigenous methodologies and leadership, and community-driven service delivery. This commentary paper focuses on Sustainable Development Goals 3, 16 and 17.
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Affiliation(s)
- Elizabeth Armstrong
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Meaghan Mcallister
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Juli Coffin
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Broome, Australia
| | - Melanie Robinson
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Broome, Australia
| | - Sandra Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Australia
| | | | | | - Lenny Papertalk
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Australia
| | - Deborah Hersh
- Speech Pathology, School of Allied Health, Curtin University, Perth, Australia
| | - Natalie Ciccone
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Jane White
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
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Jones J, Durey A, Strobel N, McAuley K, Edmond K, Coffin J, McAullay D. Perspectives of health service providers in delivering best-practice care for Aboriginal mothers and their babies during the postnatal period. BMC Pregnancy Childbirth 2023; 23:8. [PMID: 36604651 PMCID: PMC9814443 DOI: 10.1186/s12884-022-05136-6] [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: 01/31/2022] [Accepted: 10/19/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Evidence suggests that Aboriginal babies in Western Australia are not receiving adequate primary health care in their first 3 months of life, leading to questions about enablers and constraints to delivering such care. This paper presents findings from a qualitative research project investigating health providers' perceptions and experiences of best and current practice in discharge planning, postnatal care and health education for Aboriginal mothers and their newborn babies. METHODS Constructivist grounded theory guided this research involving 58 semi-structured interviews conducted with health providers who deliver care to Aboriginal mothers and infants. Participants were recruited from hospital-based and primary health sites in metropolitan Perth, and regional and remote locations in Western Australia. RESULTS Structural factors enabling best practice in discharge planning, postnatal care, and health education for mothers included health providers following best practice guidelines and adequate staffing levels. Organisational enablers included continuity of care throughout pregnancy, birth and postnatally. In particular, good communication between services around discharge planning, birth notifications, and training in culturally respectful care. Structural and organisational constraints to delivering best practice and compromising continuity of care were identified as beyond individual control. These included poor communication between different health and social services, insufficient hospital staffing levels leading to early discharge, inadequate cultural training, delayed receipt of birth notifications and discharge summaries received by Aboriginal primary health services. CONCLUSION Findings highlight the importance of examining current policies and practices to promote best practice in postnatal care to improve health outcomes for mothers and their Aboriginal babies.
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Affiliation(s)
- Jocelyn Jones
- National Drug Research Institute, Curtin University, WA, Perth, Australia.
| | - Angela Durey
- grid.1012.20000 0004 1936 7910School of Population and Global Health, The University of Western Australia, WA Perth, Australia
| | - Natalie Strobel
- grid.1038.a0000 0004 0389 4302Kurongkurl Katitjin, Edith Cowan University, WA Perth, Australia
| | - Kimberley McAuley
- grid.1012.20000 0004 1936 7910School of Population and Global Health, The University of Western Australia, WA Perth, Australia
| | - Karen Edmond
- grid.13097.3c0000 0001 2322 6764King’s College London, London, UK
| | - Juli Coffin
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, WA Perth, Australia
| | - Daniel McAullay
- grid.1038.a0000 0004 0389 4302Kurongkurl Katitjin, Edith Cowan University, WA Perth, Australia
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O'Brien P, Prehn R, Green C, Lin I, Flanagan W, Conley B, Bessarab D, Coffin J, Choong PFM, Dowsey MM, Bunzli S. Understanding the Impact and Tackling the Burden of Osteoarthritis for Aboriginal and Torres Strait Islander People. Arthritis Care Res (Hoboken) 2023; 75:125-135. [PMID: 36214055 PMCID: PMC10952431 DOI: 10.1002/acr.25004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/03/2022] [Accepted: 08/16/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to understand and describe the lived experience of Aboriginal and Torres Strait Islander people with osteoarthritis. METHODS Qualitative study guided by cultural security, which ensures that research is conducted in a way that will not compromise the cultural values, beliefs, and expectations of Aboriginal and Torres Strait Islander people. Participants were purposively sampled through the networks of project staff. Research yarns (a cultural form of conversation used as a data gathering tool) were conducted with 25 Aboriginal and Torres Strait Islander adults with self-reported osteoarthritis in Western Australia and Victoria, Australia. Data were analyzed using a framework approach and presented through composite storytelling (hypothetical stories representing an amalgam of participants' experiences). RESULTS Two composite stories were constructed to reflect themes relating to beliefs and knowledge, impact, coping, and health care experiences. Common beliefs held by participants were that osteoarthritis is caused by previous physically active lifestyles. Many participants feared for their future, increasing disability and needing a wheelchair. Pain associated with osteoarthritis impacted daily activities, sleep, work, family, and social life and cultural activities. Multidimensional impacts were often experienced within complex health or life circumstances and associated with increased anxiety and depression. Most participants reported negative health care experiences, characterized by poor patient-provider communication. CONCLUSION Our findings highlight that osteoarthritis is a multidimensional issue for Aboriginal and Torres Strait Islander people that permeates all aspects of life and highlights the need for integrated, multidisciplinary care that is culturally informed and individualized to patient need.
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Affiliation(s)
- Penny O'Brien
- The University of Melbourne, St Vincent's Hospital MelbourneMelbourneVictoriaAustralia
| | - Ryan Prehn
- The University of Melbourne, St Vincent's Hospital MelbourneMelbourneVictoriaAustralia
| | - Charmaine Green
- The University of Western Australia, Western Australian Centre for Rural HealthGeraldtonWestern AustraliaAustralia
| | - Ivan Lin
- The University of Western Australia, Western Australian Centre for Rural HealthGeraldtonWestern AustraliaAustralia
| | - Wanda Flanagan
- The University of Western Australia, Western Australian Centre for Rural HealthGeraldtonWestern AustraliaAustralia
| | - Brooke Conley
- The University of Melbourne, St Vincent's Hospital MelbourneMelbourneVictoriaAustralia
| | - Dawn Bessarab
- The University of Western Australia, Centre for Aboriginal Medical and Dental HealthPerthWestern AustraliaAustralia
| | - Juli Coffin
- Ngangk Yira Institute for Change, Murdoch UniversityMurdochWestern AustraliaAustralia
| | - Peter F. M. Choong
- The University of Melbourne, St Vincent's Hospital MelbourneMelbourneVictoriaAustralia
| | - Michelle M. Dowsey
- The University of Melbourne, St Vincent's Hospital MelbourneMelbourneVictoriaAustralia
| | - Samantha Bunzli
- The University of Melbourne, St Vincent's Hospital MelbourneMelbourneVictoriaAustralia
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Armstrong E, Rai T, Hersh D, Thompson S, Coffin J, Ciccone N, Flicker L, Cadilhac D, Godecke E, Woods D, Hayward C, Hankey GJ, McAllister M, Katzenellenbogen J. Statistical analysis plan for the stepped wedge clinical trial Healing Right Way-enhancing rehabilitation services for Aboriginal Australians after brain injury. Trials 2022; 23:886. [PMID: 36273182 PMCID: PMC9587581 DOI: 10.1186/s13063-022-06800-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aboriginal Australians are known to suffer high levels of acquired brain injury (stroke and traumatic brain injury) yet experience significant barriers in accessing rehabilitation services. The aim of the Healing Right Way trial is to evaluate a culturally secure intervention for Aboriginal people with newly acquired brain injury to improve their rehabilitation experience and quality of life. Following publication of the trial protocol, this paper outlines the statistical analysis plan prior to locking the database. METHODS: The trial involves a stepped wedge design with four steps over 3 years. Participants were 108 adult Aboriginal Australians admitted to one of eight hospitals (four rural, four urban) in Western Australia within 6 weeks of onset of a new stroke or traumatic brain injury who consented to follow-up for 26 weeks. All hospital sites started in a control phase, with the intervention assigned to pairs of sites (one metropolitan, one rural) every 26 weeks until all sites received the intervention. The two-component intervention involves training in culturally safe care for hospital sites and enhanced support provided to participants by Aboriginal Brain Injury Coordinators during their hospital stay and after discharge. The primary outcome is quality of life as measured by the Euro QOL-5D-3L VAS. A mixed effects linear regression model will be used to assess the between-group difference at 26 weeks post-injury. The model will control for injury type and severity, age at recruitment and time since commencement of the trial, as fixed effects. Recruitment site and participant will be included as random effects. Secondary outcomes include measurements of function, independence, anxiety and depression, carer strain, allied health occasions of service received and hospital compliance with minimum processes of care based on clinical guidelines and best practice models of care. DISCUSSION The trial will provide the first data surrounding the effectiveness of an intervention package for Aboriginal people with brain injury and inform future planning of rehabilitation services for this population. The statistical analysis plan outlines the analyses to be undertaken. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry ACTRN12618000139279. Registered 30 January, 2018.
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Affiliation(s)
- Elizabeth Armstrong
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | - Tapan Rai
- School of Mathematical and Physical Sciences, University of Technology Sydney, Broadway, Australia
| | - Deborah Hersh
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Sandra Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Australia
| | - Juli Coffin
- Telethon Kids Institute, Broome, Australia.,Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Broome, Australia
| | - Natalie Ciccone
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Leon Flicker
- Medical School, University of Western Australia, Perth, Australia
| | | | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University and Sir Charles Gairdner and Osborne Park Healthcare Group, Perth, Australia
| | - Deborah Woods
- Geraldton Regional Aboriginal Medical Service, Geraldton, Australia
| | - Colleen Hayward
- Centre for Indigenous Australian Education and Research, Kurongkurl Katitjin, Australia Edith Cowan University, Perth, Australia
| | - Graeme J Hankey
- Medical School, Faculty of Medical and Health Sciences, University of Western Australia, Perth, Australia
| | - Meaghan McAllister
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
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11
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O'Brien P, Thuraisingam S, Bunzli S, Lin I, Bessarab D, Coffin J, Choong PFM, Dowsey MM. Total joint replacement may be a valuable treatment for Aboriginal and Torres Strait Islander people with osteoarthritis, but uptake is low. ANZ J Surg 2022; 92:2676-2682. [PMID: 36054270 PMCID: PMC9804414 DOI: 10.1111/ans.17974] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/20/2022] [Accepted: 07/28/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Despite bearing a higher burden of osteoarthritis, little research has examined disparities in the access, utilisation and surgical outcomes associated with total joint replacement (TJR) among Aboriginal and Torres Strait Islander people. METHODS We conducted a retrospective cohort study to compare the sociodemographic and clinical characteristics of all Aboriginal and Torres Strait Islander and non-Aboriginal patients who underwent primary hip and knee replacement at St Vincent's Hospital Melbourne between 1996 and 2019. RESULTS A total of 10 277 primary total knee or hip replacements were performed in the 1996-2019 study period, of which 49 (0.5%) patients identified as either Aboriginal and/or Torres Strait Islander. Aboriginal and Torres Strait Islander patients were younger (61.7 ± 11.8 vs. 68.3 ± 10.3 years; P < 0.001), recorded higher Body Mass Index scores (median (IQR), 36.0 (29.5-41.4) vs. 30.8 (27.0-35.3); P < 0.001) and were more likely to experience multiple co-morbidities at the time of surgery. Despite these findings, Aboriginal and Torres Strait Islander patients did not experience higher complication rates and experienced comparable, clinically meaningful quality of life improvements 12-months post-surgery. CONCLUSIONS TJR appears to be a valuable treatment option for Aboriginal and Torres Strait Islander people with end-stage osteoarthritis. Our study was limited by the small number of procedures conducted in patients who identify as Aboriginal and Torres Strait Islander. Further research is needed to understand why uptake of TJR by Aboriginal and Torres Strait Islander people is low.
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Affiliation(s)
- Penny O'Brien
- The University of Melbourne, Department of SurgerySt Vincent's Hospital MelbourneMelbourneVictoriaAustralia
| | - Sharmala Thuraisingam
- The University of Melbourne, Department of SurgerySt Vincent's Hospital MelbourneMelbourneVictoriaAustralia
| | - Samantha Bunzli
- The University of Melbourne, Department of SurgerySt Vincent's Hospital MelbourneMelbourneVictoriaAustralia
| | - Ivan Lin
- The University of Western AustraliaWestern Australian Centre for Rural HealthGeraldtonWestern AustraliaAustralia
| | - Dawn Bessarab
- The University of Western AustraliaCentre for Aboriginal Medical and Dental HealthPerthWestern AustraliaAustralia
| | - Juli Coffin
- Telethon Kids InstituteBroomeWestern AustraliaAustralia
| | - Peter F. M. Choong
- The University of Melbourne, Department of SurgerySt Vincent's Hospital MelbourneMelbourneVictoriaAustralia
| | - Michelle M. Dowsey
- The University of Melbourne, Department of SurgerySt Vincent's Hospital MelbourneMelbourneVictoriaAustralia
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12
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O'Brien P, Prehn R, Rind N, Lin I, Choong PFM, Bessarab D, Coffin J, Mason T, Dowsey MM, Bunzli S. Laying the foundations of community engagement in Aboriginal health research: establishing a community reference group and terms of reference in a novel research field. Res Involv Engagem 2022; 8:40. [PMID: 35927687 PMCID: PMC9354439 DOI: 10.1186/s40900-022-00365-7] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 06/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Community engagement or community involvement in Aboriginal health research is a process that involves partnering, collaborating and involving Aboriginal and Torres Strait Islander people or potential research participants to empower them to have a say in how research with Aboriginal communities is conducted. In the context of Aboriginal health, this is particularly important so that researchers can respond to the priorities of the community under study and conduct research in a way that is respectful of Aboriginal cultural values and beliefs. One approach to incorporating the principals of community engagement and to ensure cultural oversight and guidance to projects is to engage a community reference group. The aim of this study was to describe the process of establishing an Aboriginal community reference group and terms of reference. The community reference group was established to guide the research activities of a newly formed research collaboration aiming to to develop osteoarthritis care that meets the needs of Aboriginal and Torres Strait Islander people in Australia. METHODS Adopting a Participatory Action Research approach, this two-phase study was conducted in Victoria, Australia. In phase one, semi-structured research yarns (a cultural form of conversation used as a data gathering tool) were conducted collaboratively by Aboriginal and non-Aboriginal co-investigators to explore Aboriginal health stakeholder perspectives on establishing a community reference group and terms of reference. In phase two, recommendations in phase one were identified to invite members to participate in the community reference group and to ratify the terms of reference through a focus group. Data were analyzed using a framework analysis approach. RESULTS Thirteen people (eight female, four male) participated in phase one. Participants represented diverse professional backgrounds including physiotherapy, nursing, general practice, health services management, hospital liaison, cultural safety education, health research and the arts. Three themes were identified in phase one; Recruitment and Representation (trust and relationships, in-house call-outs, broad-spectrum expertise and Aboriginal majority); Purpose (community engagement, research steering, knowledge dissemination and advocacy) and; Function and Logistics (frequency and format of meetings, size of group, roles and responsibilities, authority, communication and dissemination). In phase two, six Aboriginal people were invited to become members of the community reference group who recommended changes which were incorporated into the seven domains of the terms of reference. CONCLUSION The findings of this study are captured in a 10-step framework which describes practical strategies for establishing a community reference group and terms of reference in Aboriginal health research.
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Affiliation(s)
- Penny O'Brien
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, VIC, 3000, Australia.
| | - Ryan Prehn
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, VIC, 3000, Australia
| | - Naz Rind
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, VIC, 3000, Australia
| | - Ivan Lin
- Centre for Aboriginal Medical and Dental Health, The University of Western Australia, Perth, WA, 6000, Australia
| | - Peter F M Choong
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, VIC, 3000, Australia
| | - Dawn Bessarab
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, WA, 6530, Australia
| | - Juli Coffin
- Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, 6150, Australia
| | - Toni Mason
- ECCO Community Reference Group, Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, VIC, 3000, Australia
| | - Michelle M Dowsey
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, VIC, 3000, Australia
| | - Samantha Bunzli
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, VIC, 3000, Australia
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13
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Kishida Y, Brennan-Jones CG, Runions K, Vithiatharan R, Hancock K, Brown M, Eikelboom RH, Coffin J, Kickett-Tucker C, Li IW, Epstein M, Falconer SE, Cross D. Supporting the Social-Emotional Well-Being of Elementary School Students Who Are Deaf and Hard of Hearing: A Pilot Study. Lang Speech Hear Serv Sch 2022; 53:1037-1050. [PMID: 35914020 DOI: 10.1044/2022_lshss-21-00178] [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: 11/09/2022] Open
Abstract
PURPOSE Children who are Deaf and Hard of Hearing (DHH), their parents, Teachers of the Deaf, and other community stakeholders were involved in co-designing a web-based resource to support students' social-emotional well-being. The resource was designed to provide families and teachers with strategies to enhance the social and emotional well-being of Grade 4-6 students who are DHH. This study reports outcomes of a pilot study of the web-based resource intervention. METHOD A pre-post pilot study was conducted to quantitatively examine reported anxiety, well-being, social relationships, school experience, student-teacher relationship, and parent and teacher self-efficacy. A total of 37 students, their parents (n = 37), and their classroom teachers (n = 40) participated in the intervention program and were provided access to the resource. RESULTS In total, 19 students, 22 parents, and 17 teachers completed both pre- and postsurvey measures. Paired t tests revealed that there was a statistically significant increase in parents' self-efficacy scores from pre- to posttest. Multivariate analysis of covariance revealed a significant association between parent use of the website and student-reported improved peer support and reduced school loneliness. No other statistically significant differences were found. CONCLUSIONS The use of a web-based resource codeveloped with students who are DHH, their parents, and teachers could potentially be beneficial for the well-being of students who are DHH as well as parents' self-efficacy. Further research is needed to confirm the benefits.
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Affiliation(s)
- Yuriko Kishida
- Telethon Kids Institute, Perth, Western Australia, Australia.,Telethon Speech & Hearing, Perth, Western Australia, Australia.,Macquarie University, Sydney, New South Wales, Australia.,Curtin University, Perth, Western Australia, Australia
| | - Christopher G Brennan-Jones
- Telethon Kids Institute, Perth, Western Australia, Australia.,Curtin University, Perth, Western Australia, Australia.,Perth Children's Hospital, Child and Adolescent Health Service, Western Australia, Australia.,The University of Western Australia, Perth, Australia
| | - Kevin Runions
- Telethon Kids Institute, Perth, Western Australia, Australia.,The University of Western Australia, Perth, Australia
| | | | - Kirsten Hancock
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Michelle Brown
- Department of Education, School of Special Education Needs: Sensory, Perth, Western Australia, Australia
| | - Robert H Eikelboom
- Curtin University, Perth, Western Australia, Australia.,The University of Western Australia, Perth, Australia.,Ear Science Institute, Perth, Western Australia, Australia.,Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Juli Coffin
- Telethon Kids Institute, Perth, Western Australia, Australia.,The University of Western Australia, Perth, Australia
| | | | - Ian W Li
- The University of Western Australia, Perth, Australia
| | - Melanie Epstein
- Telethon Kids Institute, Perth, Western Australia, Australia
| | | | - Donna Cross
- Telethon Kids Institute, Perth, Western Australia, Australia.,The University of Western Australia, Perth, Australia
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14
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Thomas HM, Mullane MJ, Ang S, Barrow T, Leahy A, Whelan A, Lombardi K, Cooper M, Stevenson PG, Lester L, Padley A, Sprigg L, Speers D, Merritt AJ, Coffin J, Cross D, Gething P, Bowen AC. Acceptability of OP/Na swabbing for SARS-CoV-2: a prospective observational cohort surveillance study in Western Australian schools. BMJ Open 2022; 12:e055217. [PMID: 35082134 PMCID: PMC8808315 DOI: 10.1136/bmjopen-2021-055217] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES When the COVID-19 pandemic was declared, Governments responded with lockdown and isolation measures to combat viral spread, including the closure of many schools. More than a year later, widespread screening for SARS-CoV-2 is critical to allow schools and other institutions to remain open. Here, we describe the acceptability of a minimally invasive COVID-19 screening protocol trialled by the Western Australian Government to mitigate the risks of and boost public confidence in schools remaining open. To minimise discomfort, and optimise recruitment and tolerability in unaccompanied children, a combined throat and nasal (OP/Na) swab was chosen over the nasopharyngeal swab commonly used, despite slightly reduced test performance. DESIGN, SETTING AND PARTICIPANTS Trialling of OP/Na swabbing took place as part of a prospective observational cohort surveillance study in 79 schools across Western Australia. Swabs were collected from 5903 asymptomatic students and 1036 asymptomatic staff in 40 schools monthly between June and September 2020. OUTCOME MEASURES PCR testing was performed with a two-step diagnostic and independent confirmatory PCR for any diagnostic PCR positives. Concurrent surveys, collected online through the REDCap platform, evaluated participant experiences of in-school swabbing. RESULTS 13 988 swabs were collected from students and staff. There were zero positive test results for SARS-CoV-2, including no false positives. Participants reported high acceptability: 71% of students reported no or minimal discomfort and most were willing to be reswabbed (4% refusal rate). CONCLUSIONS OP/Na swabbing is acceptable and repeatable in schoolchildren as young as 4 years old and may combat noncompliance rates by significantly increasing the acceptability of testing. This kind of minimally-invasive testing will be key to the success of ongoing, voluntary mass screening as society adjusts to a new 'normal' in the face of COVID-19. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry-ACTRN12620000922976.
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Affiliation(s)
- Hannah M Thomas
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Marianne J Mullane
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Sherlynn Ang
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Tina Barrow
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Adele Leahy
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Alexandra Whelan
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Karen Lombardi
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Matthew Cooper
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | | | - Leanne Lester
- University of Western Australia, Perth, Western Australia, Australia
| | - Andrea Padley
- Child and Adolescent Health Service, Perth, Western Australia, Australia
| | - Lynn Sprigg
- Child and Adolescent Health Service, Perth, Western Australia, Australia
| | - David Speers
- University of Western Australia, Perth, Western Australia, Australia
- PathWest Laboratory Medicine Western Australia, Nedlands, Western Australia, Australia
| | - Adam J Merritt
- PathWest Laboratory Medicine Western Australia, Nedlands, Western Australia, Australia
| | - Juli Coffin
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- University of Western Australia, Perth, Western Australia, Australia
| | - Donna Cross
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- University of Western Australia, Perth, Western Australia, Australia
| | - Peter Gething
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Curtin University, Perth, Western Australia, Australia
| | - Asha C Bowen
- Telethon Kids Institute, Nedlands, Western Australia, Australia
- Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
- University of Western Australia, Perth, Western Australia, Australia
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15
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Thomas HM, Runions KC, Lester L, Lombardi K, Epstein M, Mandzufas J, Barrow T, Ang S, Leahy A, Mullane M, Whelan A, Coffin J, Mitrou F, Zubrick SR, Bowen AC, Gething PW, Cross D. Western Australian adolescent emotional wellbeing during the COVID-19 pandemic in 2020. Child Adolesc Psychiatry Ment Health 2022; 16:4. [PMID: 35027061 PMCID: PMC8756750 DOI: 10.1186/s13034-021-00433-y] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/13/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The impacts of the COVID-19 pandemic have been vast and are not limited to physical health. Many adolescents have experienced disruptions to daily life, including changes in their school routine and family's financial or emotional security, potentially impacting their emotional wellbeing. In low COVID-19 prevalence settings, the impact of isolation has been mitigated for most young people through continued face-to-face schooling, yet there may still be significant impacts on their wellbeing that could be attributed to the pandemic. METHODS We report on data from 32,849 surveys from Year 7-12 students in 40 schools over two 2020 survey cycles (June/July: 19,240; October: 13,609), drawn from a study of 79 primary and secondary schools across Western Australia, Australia. The Child Health Utility Index (CHU9D) was used to measure difficulties and distress in responding secondary school students only. Using comparable Australian data collected six years prior to the pandemic, the CHU9D was calibrated against the Kessler-10 to establish a reliable threshold for CHU9D-rated distress. RESULTS Compared to 14% of responding 12-18-year-olds in 2013/2014, in both 2020 survey cycles almost 40% of secondary students returned a CHU9D score above a threshold indicative of elevated difficulties and distress. Student distress increased significantly between June and October 2020. Female students, those in older Grades, those with few friendships or perceived poor quality friendships, and those with poor connectedness to school were more likely to score above the threshold. CONCLUSIONS In a large dataset collected during the first year of the COVID-19 pandemic, the proportion of secondary school students with scores indicative of difficulties and distress was substantially higher than a 2013/2014 benchmark, and distress increased as the pandemic progressed, despite the low local prevalence of COVID-19. This may indicate a general decline in social and emotional wellbeing exacerbated by the events of the pandemic. TRIAL REGISTRATION ANZCTRN (ACTRN12620000922976). Retrospectively registered 17/08/2020. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380429&isReview=true .
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Affiliation(s)
- H. M. Thomas
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - K. C. Runions
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - L. Lester
- grid.1012.20000 0004 1936 7910University of Western Australia, Perth, Australia
| | - K. Lombardi
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1038.a0000 0004 0389 4302Edith Cowan University, Perth, Australia
| | - M. Epstein
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - J. Mandzufas
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - T. Barrow
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - S. Ang
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - A. Leahy
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - M. Mullane
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - A. Whelan
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - J. Coffin
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1012.20000 0004 1936 7910University of Western Australia, Perth, Australia
| | - F. Mitrou
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - S. R. Zubrick
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - A. C. Bowen
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1012.20000 0004 1936 7910University of Western Australia, Perth, Australia ,grid.410667.20000 0004 0625 8600Perth Children’s Hospital, Perth, Australia
| | - P. W. Gething
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1032.00000 0004 0375 4078Curtin University, Perth, Australia
| | - D. Cross
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1012.20000 0004 1936 7910University of Western Australia, Perth, Australia
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16
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O’Brien P, Conley B, Bunzli S, Bullen J, Coffin J, Persaud J, Gunatillake T, Dowsey MM, Choong PF, Lin I. Staying moving, staying strong: Protocol for developing culturally appropriate information for Aboriginal people with osteoarthritis, rheumatoid arthritis, lupus and gout. PLoS One 2021; 16:e0261670. [PMID: 34941954 PMCID: PMC8699613 DOI: 10.1371/journal.pone.0261670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 12/07/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Addressing disparities in arthritis care is an important yet unmet health need for Aboriginal and Torres Strait Islander people in Australia (respectfully Aboriginal people herewith). Despite the significant prevalence and burden of arthritis within Aboriginal communities, access to care for arthritis is low. One means to reduce existing disparities in health care is to address current challenges relating to the appropriateness and acceptability of health care information resources for Aboriginal people. Health information sources can help to empower patients and their families to have greater involvement in their care and to engage in self-management of their condition. Despite an extensive range of arthritis information resources being available, currently no resources have been culturally adapted and developed in collaboration with Aboriginal consumers with arthritis. This paper outlines the processes that will be undertaken within the Staying Moving, Staying Strong project. This project aims to develop culturally secure arthritis information for Aboriginal people with osteoarthritis, rheumatoid arthritis, lupus and gout. Methods and analysis The overarching principle guiding this project is cultural security, referring to the incorporation of processes such that the research will not compromise the cultural rights, values and expectations of Aboriginal people. This project will prioritise partnerships, community engagement, community benefit, sustainability, transferability, and capacity building and therefore uphold the cultural rights and values of Aboriginal people. In this six-phase project we will; 1) Establish a community reference group and advisory committee; 2) Explore the health information needs and preferences of Aboriginal people with arthritis; 3) Synthesise the existing key recommendations in high quality clinical practice guidelines on arthritis care; 4) Culturally adapt key clinical recommendations; 5) Develop culturally appropriate arthritis resources and; 6) Qualitatively evaluate the developed resources.
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Affiliation(s)
- Penny O’Brien
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Brooke Conley
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
- * E-mail:
| | - Samantha Bunzli
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Jonathan Bullen
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Juli Coffin
- Telethon Kids Institute, Broome, WA, Australia
| | - Jennifer Persaud
- Arthritis and Osteoporosis Western Australia, Perth, WA, Australia
- Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Tilini Gunatillake
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Michelle M. Dowsey
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Peter F. Choong
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Ivan Lin
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, WA, Australia
- Geraldton Regional Aboriginal Medical Service, Geraldton, WA, Australia
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17
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Armstrong E, McCoy K, Clinch R, Merritt M, Speedy R, McAllister M, Heine K, Ciccone N, Robinson M, Coffin J. The development of aboriginal brain injury coordinator positions: a culturally secure rehabilitation service initiative as part of a clinical trial. Prim Health Care Res Dev 2021; 22:e49. [PMID: 34585654 PMCID: PMC8488978 DOI: 10.1017/s1463423621000396] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 05/10/2021] [Accepted: 05/26/2021] [Indexed: 11/07/2022] Open
Abstract
Brain injury, resulting from stroke and traumatic brain injury, is a common occurrence in Australia, with Aboriginal people affected at a significant rate and impact felt by individuals, families and communities. Access to brain injury rehabilitation services for Aboriginal people is reported to be often limited, with very little support outside the hospital environment. Our research involving Aboriginal brain injury survivors and their families to date has revealed that people often manage 'on their own' following such events. Following recommendations from survivors and their families, the Healing Right Way clinical trial, currently underway in Western Australia, has created the role of Aboriginal Brain Injury Coordinator (ABIC) to assist in navigating information and services, particularly after discharge from hospital. Eight positions for this role have been instigated across metropolitan and rural regions in the state. Healing Right Way's aim is to enhance rehabilitation services and improve quality of life for Aboriginal Australians after brain injury. The ABIC's role is to provide education, support, liaison and advocacy services to participants and their families over a six-month period, commencing soon after the participant's stroke or injury has occurred. This paper outlines the development of this role, the partnerships involved, experiences to date and identifies some facilitators and barriers encountered that may impact the role's ongoing sustainability. Details of components of the planned full Process Evaluation of Healing Right Way related to the ABIC role and the partnerships surrounding it are also provided. In combination with the trial's ultimate results, this detail will assist in future service planning and provide a model of culturally secure care for stroke and brain injury services that can also inform other sub-acute and primary care models.
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Affiliation(s)
- Elizabeth Armstrong
- Foundation Chair in Speech Pathology, Edith Cowan University, Perth, Australia
| | - Kathy McCoy
- Executive Director, Neurological Council of Western Australia, Perth, Australia
| | - Rebecca Clinch
- Aboriginal Brain Injury Coordinator, Neurological Council of Western Australia, Perth, Australia
| | - Maureen Merritt
- Aboriginal Brain Injury Coordinator, Geraldton Regional Aboriginal Medical Service, Geraldton, Australia
| | - Renee Speedy
- Aboriginal Brain Injury Coordinator, Neurological Council of Western Australia, Perth, Australia
| | - Meaghan McAllister
- Healing Right Way Project Manager, Edith Cowan University, Perth, Australia
| | - Kym Heine
- Community Nurse Consultant, Neurological Council of Western Australia, Perth, Australia
| | - Natalie Ciccone
- Associate Dean Allied Health, Edith Cowan University, Perth, Australia
| | - Melanie Robinson
- Aboriginal Research and Engagement Fellow, Murdoch University, Perth, Australia
| | - Juli Coffin
- Ellison Professor Aboriginal Health and Wellbeing, Telethon Kids Institute, the Kimberley, Nedlands, WA, Australia
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18
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Armstrong E, Coffin J, Hersh D, Katzenellenbogen JM, Thompson S, Flicker L, McAllister M, Cadilhac DA, Rai T, Godecke E, Hayward C, Hankey GJ, Drew N, Lin I, Woods D, Ciccone N. Healing Right Way: study protocol for a stepped wedge cluster randomised controlled trial to enhance rehabilitation services and improve quality of life in Aboriginal Australians after brain injury. BMJ Open 2021; 11:e045898. [PMID: 34588230 PMCID: PMC8479943 DOI: 10.1136/bmjopen-2020-045898] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Received: 10/17/2020] [Accepted: 08/31/2021] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Despite higher incidence of brain injury among Aboriginal compared with non-Aboriginal Australians, suboptimal engagement exists between rehabilitation services and Aboriginal brain injury survivors. Aboriginal patients often feel culturally insecure in hospital and navigation of services post discharge is complex. Health professionals report feeling ill-equipped working with Aboriginal patients. This study will test the impact of a research-informed culturally secure intervention model for Aboriginal people with brain injury. METHODS AND ANALYSIS: Design: Stepped wedge cluster randomised control trial design; intervention sequentially introduced at four pairs of healthcare sites across Western Australia at 26-week intervals.Recruitment: Aboriginal participants aged ≥18 years within 4 weeks of an acute stroke or traumatic brain injury.Intervention: (1) Cultural security training for hospital staff and (2) local, trial-specific, Aboriginal Brain Injury Coordinators supporting participants.Primary outcome: Quality-of-life using EuroQOL-5D-3L (European Quality of Life scale, five dimensions, three severity levels) Visual Analogue Scale score at 26 weeks post injury. Recruitment of 312 participants is estimated to detect a difference of 15 points with 80% power at the 5% significance level. A linear mixed model will be used to assess the between-condition difference.Secondary outcome measures: Modified Rankin Scale, Functional Independence Measure, Modified Caregiver Strain Index, Hospital Anxiety and Depression Scale at 12 and 26 weeks post injury, rehabilitation occasions of service received, hospital compliance with minimum care processes by 26 weeks post injury, acceptability of Intervention Package, feasibility of Aboriginal Brain Injury Coordinator role.Evaluations: An economic evaluation will determine the potential cost-effectiveness of the intervention. Process evaluation will document fidelity to study processes and capture changing contexts including barriers to intervention implementation and acceptability/feasibility of the intervention through participant questionnaires at 12 and 26 weeks. ETHICS AND DISSEMINATION The study has approvals from Aboriginal, university and health services human research ethics committees. Findings will be disseminated through stakeholder reports, participant workshops, peer-reviewed journal articles and conference papers. TRIAL REGISTRATION NUMBER ACTRN12618000139279.
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Affiliation(s)
- Elizabeth Armstrong
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Juli Coffin
- Telethon Kids Institute, Broome, Western Australia, Australia
| | - Deborah Hersh
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Judith M Katzenellenbogen
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Sandra Thompson
- Western Australian Centre for Rural Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Leon Flicker
- WA Centre for Health and Ageing, University of Western Australia, Perth, Western Australia, Australia
| | - Meaghan McAllister
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | | | - Tapan Rai
- School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Colleen Hayward
- School of Kurongkurl Katitjin, Edith Cowan University, Mount Lawley, Western Australia, Australia
| | - Graeme J Hankey
- School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, Australia
| | - Neil Drew
- School of Kurongkurl Katitjin, Edith Cowan University, Mount Lawley, Western Australia, Australia
| | - Ivan Lin
- Western Australian Centre for Rural Health, University of Western Australia - Geraldton Campus, Geraldton, Western Australia, Australia
- Geraldton Regional Aboriginal Medical Service, Geraldton, Western Australia, Australia
| | - Deborah Woods
- Geraldton Regional Aboriginal Medical Service, Geraldton, Western Australia, Australia
| | - Natalie Ciccone
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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Armstrong E, Coffin J, Hersh D, Katzenellenbogen JM, Thompson SC, Ciccone N, Flicker L, Woods D, Hayward C, Dowell C, McAllister M. "You felt like a prisoner in your own self, trapped": the experiences of Aboriginal people with acquired communication disorders. Disabil Rehabil 2021; 43:1903-1916. [PMID: 31692386 DOI: 10.1080/09638288.2019.1686073] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 12/18/2018] [Revised: 10/23/2019] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Aboriginal Australians are under-represented in brain injury rehabilitation services despite a high incidence of both stroke and traumatic brain injury in this population. This study aimed to explore the experiences of Aboriginal Australian adults with acquired communication disorders (ACDs) after brain injury for the first time to inform the development of accessible and culturally secure service delivery models. METHODS AND MATERIALS Semi-structured interviews were undertaken with 32 Aboriginal people who had experienced a brain injury resulting in ACDs (aged 35-79 years) and 18 family members/carers across Western Australia. Thematic analysis identified common themes across participants. RESULTS Overall themes related to communication (both related to the communication disorder and general healthcare interactions), health and social contexts, recovery, and support, being away from family and country, knowledge and beliefs about brain injury, and follow-up. CONCLUSIONS An increase in healthcare staff's appreciation of the health and social contexts of Aboriginal people after brain injury is needed in order to improve communication with Aboriginal patients and the ability to offer accessible rehabilitation services. Ongoing support is required, with cultural identity noted as key to ensuring cultural security and ultimately recovery. Involvement of family and other Aboriginal people in recovery processes, as well as access to relevant Aboriginal languages and proximity to ancestral lands is central.Implications for rehabilitationAcknowledgment of cultural identity and strengths through involvement of extended family and Aboriginal Hospital Liaison Officers, access to language and proximity to country all central to rehabilitation planning for Aboriginal people after brain injury.Cultural security training for rehabilitation staff is recommended focusing on clear two-way communication skills to make medical information accessible for Aboriginal patients and to listen to patients' concerns in a way that respects cultural context.Information regarding practical support and implications for ongoing management of life after brain injury (for the person and their family) is essential, and should supplement the medical-related information provided.Follow-up post discharge from hospital best facilitated through establishing contact with local Aboriginal community through Aboriginal community controlled health services, community elders, and Aboriginal health workers across organisations.
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Affiliation(s)
- Elizabeth Armstrong
- School of Medical & Health Sciences, Edith Cowan University, Perth, Australia
| | | | - Deborah Hersh
- School of Medical & Health Sciences, Edith Cowan University, Perth, Australia
| | - Judith M Katzenellenbogen
- School of Population and Global Health, University of Western Australia, Perth, Australia
- Telethon Kids Institute, Perth, Australia
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Australia
| | - Natalie Ciccone
- School of Medical & Health Sciences, Edith Cowan University, Perth, Australia
| | - Leon Flicker
- Centre for Medical Research, University of Western Australia, Perth, Australia
| | - Deborah Woods
- Geraldton Regional Aboriginal Medical Service, Geraldton, Australia
| | - Colleen Hayward
- Kurongkurl Katitjin, Centre for Indigenous Australian Education and Research, Edith Cowan University, Perth, Australia
| | - Catelyn Dowell
- School of Medical & Health Sciences, Edith Cowan University, Perth, Australia
| | - Meaghan McAllister
- School of Medical & Health Sciences, Edith Cowan University, Perth, Australia
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Wright M, Brown A, Dudgeon P, McPhee R, Coffin J, Pearson G, Lin A, Newnham E, King Baguley K, Webb M, Sibosado A, Crisp N, Flavell HL. Our journey, our story: a study protocol for the evaluation of a co-design framework to improve services for Aboriginal youth mental health and well-being. BMJ Open 2021; 11:e042981. [PMID: 34011581 PMCID: PMC8137218 DOI: 10.1136/bmjopen-2020-042981] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [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] [Received: 07/24/2020] [Revised: 03/10/2021] [Accepted: 04/14/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Mainstream Australian mental health services are failing Aboriginal young people. Despite investing resources, improvements in well-being have not materialised. Culturally and age appropriate ways of working are needed to improve service access and responsiveness. This Aboriginal-led study brings Aboriginal Elders, young people and youth mental health service staff together to build relationships to co-design service models and evaluation tools. Currently, three Western Australian youth mental health services in the Perth metropolitan area and two regional services are working with local Elders and young people to improve their capacity for culturally and age appropriate services. Further Western Australian sites will be engaged as part of research translation. METHODS AND ANALYSIS Relationships ground the study, which utilises Indigenous methodologies and participatory action research. This involves Elders, young people and service staff as co-researchers and the application of a decolonising, strengths-based framework to create the conditions for engagement. It foregrounds experiential learning and Aboriginal ways of working to establish relationships and deepen non-Aboriginal co-researchers' knowledge and understanding of local, place-based cultural practices. Once relationships are developed, co-design workshops occur at each site directed by local Elders and young people. Co-designed evaluation tools will assess any changes to community perceptions of youth mental health services and the enablers and barriers to service engagement. ETHICS AND DISSEMINATION The study has approval from the Kimberley Aboriginal Health Planning Forum Kimberley Research Subcommittee, the Western Australian Aboriginal Health Ethics Committee, and the Curtin University Human Research Ethics Committee. Transferability of the outcomes across the youth mental health sector will be directed by the co-researchers and is supported through Aboriginal and non-Aboriginal organisations including youth mental health services, peak mental health bodies and consumer groups. Community reports and events, peer-reviewed journal articles, conference presentations and social and mainstream media will aid dissemination.
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Affiliation(s)
- Michael Wright
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Alex Brown
- Indigenous Health, SAHMRI, Adelaide, South Australia, Australia
| | - Patricia Dudgeon
- School of Indigenous Studies, The University of Western Australia, Perth, Western Australia, Australia
| | - Rob McPhee
- Kimberley Aboriginal Medical Service, Broome, Western Australia, Australia
| | - Juli Coffin
- Telethon Kids Institute, Broome, Western Australia, Australia
| | - Glenn Pearson
- Aboriginal Health Institute Leadership Team, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Ashleigh Lin
- Telethon Institute for Child Health Research, Nedlands, Western Australia, Australia
| | - Elizabeth Newnham
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | | | - Michelle Webb
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Amanda Sibosado
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Nikayla Crisp
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
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21
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McKivett A, Glover K, Clark Y, Coffin J, Paul D, Hudson JN, O'Mara P. The role of governance in Indigenous medical education research. Rural Remote Health 2021; 21:6473. [PMID: 33887949 DOI: 10.22605/rrh6473] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
CONTEXT This article considers the role of governance in Indigenous medical education research through the lens of an Australian Aboriginal research project titled Healing Conversations. The Healing Conversations project is developing and testing a targeted educational framework for improved clinical communication between healthcare practitioners and Australian Aboriginal peoples in regional and urban locations. It is proposed that an effective governance approach can support Indigenous and non-Indigenous stakeholders to work together in decision-making structures to enable outcomes that promote and prioritise Indigenous worldviews and values in medical education research. ISSUE The case study explored here puts forth the notion of effective governance as one practical way to decolonise medical education research structures in both the urban and regional setting. The importance of relationships between Indigenous and non-Indigenous stakeholders is supported in tailored governance structures, as knowledge translation efforts are situated in mainstream tertiary education structures that hold collective responsibility and accountability for change in this space. LESSONS LEARNT Reflections from the Healing Conversations research case study are outlined for future consideration regarding sustainable and effective Indigenous governance initiatives in medical education and research structures. This includes the importance of an Indigenous governance structure within the research team and a strong understanding of the roles and contributions of each research team member, along with the required humanistic qualities to action effective governance in Indigenous medical education research. Collaborative governance structures are fundamental as the inclusion and prioritisation of Indigenous worldviews and values is a key step in redressing Indigenous healthcare disparities and providing culturally safe healthcare institutions.
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Affiliation(s)
- Andrea McKivett
- Adelaide Rural Clinical School, Port Augusta Site Office, The University of Adelaide, Adelaide, SA 5077, Australia
| | - Karen Glover
- Aboriginal Communities and Families Health Research Alliance, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia; and Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic. 3052, Australia
| | - Yvonne Clark
- Aboriginal Communities and Families Health Research, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia; and Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Vic. 3052, Australia
| | - Juli Coffin
- Head Social and Emotional Wellbeing of Aboriginal Young People, Telethon Kids Institute, Broome, WA 6725, Australia
| | - David Paul
- School of Medicine Fremantle, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Judith Nicoll Hudson
- School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Peter O'Mara
- Thurru Indigenous Health Unit, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW 2300, Australia
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22
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O'Brien P, Bunzli S, Lin I, Bessarab D, Coffin J, Dowsey MM, Choong PFM. Addressing surgical inequity for Aboriginal and Torres Strait Islander people in Australia's universal health care system: a call to action. ANZ J Surg 2021; 91:238-244. [PMID: 33506978 DOI: 10.1111/ans.16557] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 09/20/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 11/29/2022]
Abstract
Aboriginal and Torres Strait Islander people continue to experience health inequity within the Australian health care system. Little research has examined how disparities in surgical care access and outcomes contribute to Aboriginal health. In this narrative review and call to action, we discuss five care points along the journey to high-quality surgical care: health care seeking, primary health care services, specialist services, surgery and surgical outcomes. We highlight barriers and disparities that exist along this journey, drawing examples from the field of joint replacement surgery. Finally, we present opportunities for change at the health system, health service and clinician level, calling upon researchers, clinicians and policy makers to confront the surgical disparities experienced by Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Penny O'Brien
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Samantha Bunzli
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ivan Lin
- Western Australian Centre for Rural Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Juli Coffin
- Social and Emotional Wellbeing of Aboriginal Young People, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Michelle M Dowsey
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peter F M Choong
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
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Mullane MJ, Thomas HM, Epstein M, Mandzufas J, Mullan N, Whelan A, Lombardi K, Barrow T, Ang S, Leahy A, Cameron E, Lester L, Cooper M, Stevenson P, Hartman M, McKenzie A, Mitrou F, Zubrick SR, Coffin J, Cross D, Bowen AC, Gething P. DETECT Schools Study Protocol: A Prospective Observational Cohort Surveillance Study Investigating the Impact of COVID-19 in Western Australian Schools. Front Public Health 2021; 9:636921. [PMID: 33692984 PMCID: PMC7937789 DOI: 10.3389/fpubh.2021.636921] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/06/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction: Amidst the evolving COVID-19 pandemic, understanding the transmission dynamics of the SARS-CoV-2 virus is key to providing peace of mind for the community and informing policy-making decisions. While available data suggest that school-aged children are not significant spreaders of SARS-CoV-2, the possibility of transmission in schools remains an ongoing concern, especially among an aging teaching workforce. Even in low-prevalence settings, communities must balance the potential risk of transmission with the need for students' ongoing education. Through the roll out of high-throughput school-based SARS-CoV-2 testing, enhanced follow-up for individuals exposed to COVID-19 and wellbeing surveys, this study investigates the dynamics of SARS-CoV-2 transmission and the current psychosocial wellbeing impacts of the pandemic in school communities. Methods: The DETECT Schools Study is a prospective observational cohort surveillance study in 79 schools across Western Australia (WA), Australia. To investigate the incidence, transmission and impact of SARS-CoV-2 in schools, the study comprises three "modules": Module 1) Spot-testing in schools to screen for asymptomatic SARS-CoV-2; Module 2) Enhanced surveillance of close contacts following the identification of any COVID-19 case to determine the secondary attack rate of SARS-CoV-2 in a school setting; and Module 3) Survey monitoring of school staff, students and their parents to assess psycho-social wellbeing following the first wave of the COVID-19 pandemic in WA. Clinical Trial Registration: Trial registration number: ACTRN12620000922976.
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Affiliation(s)
| | | | - Melanie Epstein
- Telethon Kids Institute, Perth, WA, Australia
- Cancer Council Western Australia, Perth, WA, Australia
| | | | | | | | - Karen Lombardi
- Telethon Kids Institute, Perth, WA, Australia
- Cancer Council Western Australia, Perth, WA, Australia
- Edith Cowan University, Perth, WA, Australia
| | - Tina Barrow
- Telethon Kids Institute, Perth, WA, Australia
| | | | - Adele Leahy
- Telethon Kids Institute, Perth, WA, Australia
| | - Ewan Cameron
- Telethon Kids Institute, Perth, WA, Australia
- Curtin University, Perth, WA, Australia
| | - Leanne Lester
- Cancer Council Western Australia, Perth, WA, Australia
| | - Matt Cooper
- Telethon Kids Institute, Perth, WA, Australia
| | | | | | | | | | | | - Juli Coffin
- Telethon Kids Institute, Perth, WA, Australia
- University of Western Australia, Perth, WA, Australia
| | - Donna Cross
- Telethon Kids Institute, Perth, WA, Australia
- University of Western Australia, Perth, WA, Australia
| | - Asha C. Bowen
- Telethon Kids Institute, Perth, WA, Australia
- University of Western Australia, Perth, WA, Australia
- Child and Adolescent Health Service, Perth, WA, Australia
| | - Peter Gething
- Telethon Kids Institute, Perth, WA, Australia
- Curtin University, Perth, WA, Australia
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Eades A, Hackett ML, Liu H, Brown A, Coffin J, Cass A. Qualitative study of psychosocial factors impacting on Aboriginal women's management of chronic disease. Int J Equity Health 2020; 19:8. [PMID: 31931810 PMCID: PMC6958573 DOI: 10.1186/s12939-019-1110-3] [Citation(s) in RCA: 6] [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: 09/20/2019] [Accepted: 12/11/2019] [Indexed: 11/30/2022] Open
Abstract
Background Aboriginal women are frequently called upon to support their families and other community members. At times, such supporting roles can be burdensome for these women. Many Aboriginal women live with chronic conditions. We explored the ways in which the women’s caring roles impacted on how they maintained their own health. Methods The aim of this manuscript is to explore the psychosocial factors associated with the management of health and chronic disease in Aboriginal women. An interpretive phenomenological approach was used for the analysis of 72 in-depth semi-structured interviews. These interviews were conducted in four community controlled Aboriginal health services, in urban, rural and remote settings, across two states and a territory in Australia. Results Women living with chronic disease experience multiple challenges while caring for family, such as intergenerational trauma, mental health issues relating to addiction, domestic and family violence and incarceration. When these women become ill, they also have to take care of themselves. These women provided informal and unfunded care in response to a range of complex family and community problems. This continuous caring for family affected the women’s ability to maintain their health and manage their own chronic conditions. Conclusion The caring roles and responsibilities Aboriginal women have in their community impact on their health. Aboriginal women provide much needed refuge and support to family and the wider community. Underfunded and over-burdened formal support services are not meeting the needs of many Aboriginal women. Improved culturally secure resources and social services are required within communities to support Aboriginal women to successfully manage their own health.
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Affiliation(s)
- A Eades
- The George Institute for Global Health, The University of New South Wales, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia. .,The University of Sydney, Sydney, Australia.
| | - M L Hackett
- The George Institute for Global Health, The University of New South Wales, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.,The University of Sydney, Sydney, Australia
| | - H Liu
- The George Institute for Global Health, The University of New South Wales, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.,The University of Sydney, Sydney, Australia
| | - A Brown
- South Australian Health & Medical Research Institute, Adelaide, South Australia
| | - J Coffin
- Telethon Kids Institute Australian Medical Research Institute, Perth, Western Australia
| | - A Cass
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
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Joseph K, Halvas E, Brandt L, Patro S, Rausch J, Kearney M, Coffin J, Mellors J. High-throughput sequencing of integrated HIV-1 reveals novel proviral structures. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30138-2] [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: 10/23/2022] Open
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Hasson J, Katusiime M, Smith S, Cotton M, Boritz E, Coffin J, Mellors J, Patro S, Van Zyl G, Kearney M. Proviral landscape in children parallels adults and enables reservoir reconstruction. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30136-9] [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: 11/29/2022] Open
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Patro S, Niyongabo A, Guo S, Wu X, Boritz E, Deeks S, Maldarelli F, Hughes S, Coffin J, Kearney M. HIV proviruses with identical sequences arise from cell expansion and infection by a common ancestor virus. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30140-0] [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: 11/28/2022] Open
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Bale M, Katusiime M, Wells D, Wu X, Coffin J, Cotton M, Hughes S, Mellors J, Van Zyl G, Kearney M. Long-term persistence of HIV-infected cell clones in early treated children. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30146-1] [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: 10/23/2022] Open
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29
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Hersh D, Armstrong E, McAllister M, Ciccone N, Katzenellenbogen J, Coffin J, Thompson S, Hayward C, Flicker L, Woods D. General practitioners' perceptions of their communication with Australian Aboriginal patients with acquired neurogenic communication disorders. Patient Educ Couns 2019; 102:2310-2317. [PMID: 31427169 DOI: 10.1016/j.pec.2019.07.029] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 07/12/2019] [Accepted: 07/23/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Aboriginal people have high rates of stroke and traumatic brain injury (TBI), often with residual, chronic communication deficits and multiple co-morbidities. This study examined general practitioners' (GPs') perceptions of their communication with Aboriginal patients with acquired communication disorders (ACD) after brain injury. Effective communication underpins good care but no previous research has explored this specific context. METHODS A qualitative descriptive approach was employed using interviews and focus groups with 23 GPs from metropolitan Perth and five regional sites in Western Australia. Data were analysed thematically. RESULTS GPs reported low visibility of Aboriginal patients with ACD in their practices, minimal training on neurogenic ACD, and difficulty distinguishing ACD from cultural-linguistic factors. They had few communication resources, and depended on families and Aboriginal Health Workers to assist in interactions. They rarely used formal interpreting services or referred to speech pathology. They reported communication (dis)ability having low priority in consultations. CONCLUSION GPs report difficulty recognising ACD and their lack of prioritising assessment and treatment of communication ability after brain injury potentially compounds the disadvantage and disempowerment experienced by many Aboriginal people. PRACTICE IMPLICATIONS GPs require further communication and cultural training. Improved access to speech pathology and formal interpreting services would be beneficial.
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Affiliation(s)
- Deborah Hersh
- Speech Pathology, Edith Cowan University, Perth, Australia.
| | | | | | | | - Judith Katzenellenbogen
- Telethon Kids Institute, Broome and Perth, Australia; WA Centre for Rural Health, University of Western Australia, Perth, Australia
| | - Juli Coffin
- Telethon Kids Institute, Broome and Perth, Australia
| | - Sandra Thompson
- WA Centre for Rural Health, University of Western Australia, Perth, Australia
| | | | - Leon Flicker
- WA Centre for Rural Health, University of Western Australia, Perth, Australia; Royal Perth Hospital, University of Western Australia, Perth, Australia
| | - Deborah Woods
- Geraldton Regional Aboriginal Medical Service, Geraldton, Australia
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Shao W, Shan J, Hu W, Halvas E, Mellors J, Coffin J, Kearney M. Updates on two public databases for studies of HIV persistence; the Retrovirus Integration Database (RID) and HIV Proviral Sequence Database (PSD). J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30103-5] [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: 11/16/2022] Open
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31
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Coffin J. The Nguudu Barndimanmanha Project-Improving Social and Emotional Wellbeing in Aboriginal Youth Through Equine Assisted Learning. Front Public Health 2019; 7:278. [PMID: 31649910 PMCID: PMC6795701 DOI: 10.3389/fpubh.2019.00278] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 07/16/2018] [Accepted: 09/13/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Recent statistics have painted a grim picture for Australia's Aboriginal youth, with reports of higher levels of almost every health indicator, including depression, sexual and emotional abuse, unemployment, and incarceration. Traditional western based therapies have proven to have limited effectiveness in engaging this group as they can often be culturally inappropriate. International studies have provided promising results using equine assisted learning, with a sound methodological basis underpinned by Indigenous ways of being and doing. In Australia Aboriginal people have strong historical ties to horses through their work on stations and were often considered some of the country's best horsemen and women. While equine assisted learning programs exist in Australia there are currently none catering specifically to Aboriginal youth, run and staffed by Aboriginal staff and provided in a culturally secure manner. Aims: Alternative therapy for Aboriginal youth in the areas of grief, loss, and trauma, through an equine assisted learning program that focussed on self-concept, self-regulation, self-awareness, anxiety and depression, and sense of connectedness. Methods: Participants (N = 270) aged 6–25 years old engaged in a minimum of 6-weeks of equine assisted learning. Each session was 45–50 min duration and occurred on a weekly basis. Sessions were undertaken individually, in pairs and in groups, depending on the needs of the participant and the focus of the session goals. Qualitative examination of the participants included photography to capture the lived experiences of the participants throughout the program. In addition an cultural and age appropriate adaptation of the Strength and Difficulties Questionnaire was trialed to track changes quantitively. Conclusion: We observed improvements in self-regulation, self-awareness, and socialization skills, evident from the photography recording and the questionnaire data. In addition parent and/or caregiver and teacher reported changes in behavior, self-regulation, and socialization skills were recorded.
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Affiliation(s)
- Juli Coffin
- Telethon Kids Institute, Nedlands, WA, Australia.,Geraldton Regional Aboriginal Medical Service, Rangeway, WA, Australia.,The University of Notre Dame Australia, Broome, WA, Australia
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Mullane MJ, Barnett TC, Cannon JW, Carapetis JR, Christophers R, Coffin J, Jones MA, Marsh JA, Mc Loughlin F, O'Donnell V, Pavlos R, Smith B, Steer AC, Tong SYC, Walker R, Bowen AC. SToP (See, Treat, Prevent) skin sores and scabies trial: study protocol for a cluster randomised, stepped-wedge trial for skin disease control in remote Western Australia. BMJ Open 2019; 9:e030635. [PMID: 31551385 PMCID: PMC6773324 DOI: 10.1136/bmjopen-2019-030635] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 12/26/2022] Open
Abstract
INTRODUCTION Skin is important in Australian Aboriginal culture informing kinship and identity. In many remote Aboriginal communities, scabies and impetigo are very common. Untreated skin infections are painful, itchy and frequently go untreated due to under-recognition and lack of awareness of their potential serious complications. We hypothesise that the skin infection burden in remote Aboriginal communities can be reduced by implementing streamlined training and treatment pathways integrated with environmental health and health promotion activities, tested in the See, Treat, Prevent (SToP skin sores and scabies) trial. METHODS AND ANALYSIS SToP will evaluate a skin control programme using a stepped-wedge, cluster randomised trial design with three intervention components (the 'SToP activities'): (1) seeing skin infections (development of training resources implemented within a community dermatology model); (2) treating skin infections (employing the latest evidence for impetigo, and scabies treatment); and (3) preventing skin infections (embedded, culturally informed health promotion and environmental health activities). Four community clusters in the remote Kimberley region of Western Australia will participate. Following baseline data collection, two clusters will be randomly allocated to the SToP activities. At 12 months, the remaining two clusters will transition to the SToP activities. The primary outcome is the diagnosis of impetigo in children (5-9 years) at school-based surveillance. Secondary outcome measures include scabies diagnosis, other child health indicators, resistance to cotrimoxazole in circulating pathogenic bacteria, determining the economic burden of skin disease and evaluating the cost effectiveness of SToP activities. ETHICS AND DISSEMINATION This study protocol was approved by the health ethics review committees at the Child and Adolescent Health Service (Approval number RGS0000000584), the Western Australian Aboriginal Health Ethics Committee (Reference number: 819) and the University of Western Australia (Reference RA/4/20/4123). Study findings will be shared with community members, academic and medical communities via publications and presentations, and in reports to funders. Authorship for all publications based on this study will be determined in line with the Uniform Requirements for Manuscripts Submitted to Biomedical Journals published by the International Committee of Medical Journal Editors. Sharing results with organisations and communities who contributed to the study is paramount. The results of the SToP trial will be shared with participants in a suitable format, such as a single summary page provided to participants or presentations to communities, the Kimberly Aboriginal Health Planning Forum Research Subcommittee and other stakeholders as appropriate and as requested. Communication and dissemination will require ongoing consultation with Aboriginal communities to determine appropriate formats. TRIAL REGISTRATION NUMBER ACTRN12618000520235.
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Affiliation(s)
- Marianne J Mullane
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Timothy C Barnett
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Jeffrey W Cannon
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Jonathan R Carapetis
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
- Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia
- Department of Paediatric Infectious Diseases, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Ray Christophers
- Nirrumbuk Environmental Health & Services, Nirrumbuk Aboriginal Corporation, Broome, Western Australia, Australia
| | - Juli Coffin
- Aboriginal Health, Telethon Kids Kimberley, Telethon Kids Institute, University of Western Australia, Broome, Western Australia, Australia
- Nulungu Research Institute, University of Notre Dame, Broome, Western Australia, Australia
| | - Mark A Jones
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Julie A Marsh
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Frieda Mc Loughlin
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Vicki O'Donnell
- Kimberley Aboriginal Medical Services, Broome, Western Australia, Australia
| | - Rebecca Pavlos
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Bec Smith
- Western Australian Country Health Services-Kimberley, Broome, Western Australia, Australia
| | - Andrew C Steer
- Tropical Diseases Research Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Department of General Paediatrics, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Steven Y C Tong
- Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital and The University of Melbourne, Melbourne, Victoria, Australia
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Roz Walker
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Asha C Bowen
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
- Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia
- Department of Paediatric Infectious Diseases, Perth Children's Hospital, Nedlands, Western Australia, Australia
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
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Lin IB, Bunzli S, Mak DB, Green C, Goucke R, Coffin J, O'Sullivan PB. Unmet Needs of Aboriginal Australians With Musculoskeletal Pain: A Mixed-Method Systematic Review. Arthritis Care Res (Hoboken) 2019; 70:1335-1347. [PMID: 29245188 DOI: 10.1002/acr.23493] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/05/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Musculoskeletal pain (MSP) conditions are the biggest cause of disability, and internationally, indigenous peoples experience a higher burden. There are conflicting reports about Aboriginal Australians and MSP. We conducted a systematic review to describe the prevalence, associated factors, impacts, care access, health care experiences, and factors associated with MSP among Aboriginal Australians. METHODS We used a systematic search of quantitative and qualitative scientific and grey literature (PROSPERO# CRD42016038342). Articles were appraised using the Mixed Methods Appraisal Tool. Due to study heterogeneity, a narrative synthesis was conducted. RESULTS Of 536 articles identified, 18 were included (14 quantitative, 4 qualitative), of high (n = 11), medium (n = 2), and low (n = 5) quality. Prevalence of MSP in Aboriginal populations was similar to or slightly higher than the non-Aboriginal population (prevalence rate ratio 1.1 for back pain, 1.2-1.5 for osteoarthritis [OA], and 1.0-2.0 for rheumatoid arthritis). Aboriginal people accessed primary care for knee or hip OA at approximately half the rate of non-Aboriginal people, and were less than half as likely to have knee or hip replacement surgery. Communication difficulties with health practitioners were the main reason why Aboriginal people with MSP choose not to access care. No articles reported interventions. CONCLUSION Findings provide preliminary evidence of an increased MSP burden among Aboriginal Australians, and particularly for OA, a mismatch between the disease burden and access to health care. To increase accessibility, health services should initially focus on improving Aboriginal patients' experiences of care, in particular by improving patient-practitioner communication. Implications for care and research are outlined.
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Affiliation(s)
- Ivan B Lin
- University of Western Australia, Geraldton, Western Australia, Australia
| | | | - Donna B Mak
- University of Notre Dame Australia School of Medicine, Fremantle, Western Australia, Australia
| | - Charmaine Green
- University of Western Australia, Geraldton, Western Australia, Australia
| | - Roger Goucke
- Sir Charles Gardner Hospital, Perth, Western Australia, Australia
| | - Juli Coffin
- University of Notre Dame Australia, Broome, Western Australia, Australia
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Parnell A, Box E, Biagioni N, Bonevski B, Coffin J, Slevin T, Anwar-McHenry J, Pettigrew S. Attitudinal and behavioural responses to increasing tobacco control regulation among high smoking prevalence groups: A qualitative study. Drug Alcohol Rev 2018; 38:92-100. [DOI: 10.1111/dar.12869] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 07/01/2018] [Accepted: 09/19/2018] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Billie Bonevski
- School of Medicine and Public Health; University of Newcastle; Newcastle Australia
| | - Juli Coffin
- Broome Campus; University of Notre Dame; Broome Australia
| | - Terry Slevin
- School of Psychology; Curtin University; Perth Australia
- Cancer Council WA; Perth Australia
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Lin I, Mak DB, Coffin J, OˈSullivan P. Primary care management of non‐specific low back pain: key messages from recent clinical guidelines. Med J Aust 2018; 209:235. [DOI: 10.5694/mja18.00408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 05/03/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Ivan Lin
- WA Centre for Rural Health, University of Western Australia, Geraldton, WA
| | - Donna B Mak
- University of Notre Dame Australia, Fremantle, WA
| | - Juli Coffin
- University of Notre Dame Australia, Broome, WA
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Lin IB, Ryder K, Coffin J, Green C, Dalgety E, Scott B, Straker LM, Smith AJ, O'Sullivan PB. Addressing Disparities in Low Back Pain Care by Developing Culturally Appropriate Information for Aboriginal Australians: "My Back on Track, My Future". Pain Med 2018; 18:2070-2080. [PMID: 28087847 DOI: 10.1093/pm/pnw314] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives Addressing disparities in low back pain care (LBP) is an important yet largely unaddressed issue. One avenue to addressing disparities, recommended by clinical guidelines, is to ensure that LBP information is culturally appropriate. Our objectives were, first, to develop LBP information that was culturally appropriate for Aboriginal Australians living in a rural area and, second, to compare this to traditional information. Methods The overall information development process was guided by a "cultural security" framework and included partnerships between Aboriginal/non-Aboriginal investigators, a synthesis of research evidence, and participation of a project steering group consisting of local Aboriginal people. LBP information (entitled My Back on Track, My Future [MBOT]) was developed as five short audio-visual scenarios, filmed using Aboriginal community actors. A qualitative randomized crossover design compared MBOT with an evidence-based standard (the Back Book [BB]). Twenty Aboriginal adults participated. Qualitatively we ascertained which information participants' preferred and why, perceptions about each resource, and LBP management. Results Thirteen participants preferred MBOT, four the BB, two both, and one neither. Participants valued seeing "Aboriginal faces," language that was understandable, the visual format, and seeing Aboriginal people undertaking positive changes in MBOT. In contrast, many participants found the language and format of the BB a barrier. Participants who preferred the BB were more comfortable with written information and appreciated the detailed content. Conclusions The MBOT information was more preferred and addressed important barriers to care, providing support for use in practice. Similar processes are needed to develop pain information for other cultural groups, particularly those underserved by existing approaches to care.
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Affiliation(s)
- Ivan B Lin
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, Western Australia
| | - Kim Ryder
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, Western Australia
| | - Juli Coffin
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia.,Geraldton Regional Aboriginal Medical Service, Geraldton, Western Australia.,Notre Dame University, Broome, Western Australia
| | - Charmaine Green
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, Western Australia.,Geraldton Regional Aboriginal Medical Service, Geraldton, Western Australia
| | - Eric Dalgety
- Geraldton Regional Aboriginal Medical Service, Geraldton, Western Australia
| | - Brian Scott
- Geraldton Regional Aboriginal Medical Service, Geraldton, Western Australia
| | - Leon M Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia
| | - Anne J Smith
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia
| | - Peter B O'Sullivan
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia
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Anderson E, Bell J, Kearney M, Coffin J, Maldarelli F. HIV viremia is the product of a small fraction of infected cells. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30608-7] [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: 11/25/2022] Open
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Armstrong EM, Ciccone N, Hersh D, Katzenellebogen J, Coffin J, Thompson S, Flicker L, Hayward C, Woods D, McAllister M. Development of the Aboriginal Communication Assessment After Brain Injury (ACAABI): A screening tool for identifying acquired communication disorders in Aboriginal Australians. Int J Speech Lang Pathol 2017; 19:297-308. [PMID: 28425776 DOI: 10.1080/17549507.2017.1290136] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 01/30/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Acquired communication disorders (ACD), following stroke and traumatic brain injury, may not be correctly identified in Aboriginal Australians due to a lack of linguistically and culturally appropriate assessment tools. Within this paper we explore key issues that were considered in the development of the Aboriginal Communication Assessment After Brain Injury (ACAABI) - a screening tool designed to assess the presence of ACD in Aboriginal populations. METHOD A literature review and consultation with key stakeholders were undertaken to explore directions needed to develop a new tool, based on existing tools and recommendations for future developments. RESULT The literature searches revealed no existing screening tool for ACD in these populations, but identified tools in the areas of cognition and social-emotional wellbeing. Articles retrieved described details of the content and style of these tools, with recommendations for the development and administration of a new tool. The findings from the interview and focus group views were consistent with the approach recommended in the literature. CONCLUSIONS There is a need for a screening tool for ACD to be developed but any tool must be informed by knowledge of Aboriginal language, culture and community input in order to be acceptable and valid.
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Affiliation(s)
| | - Natalie Ciccone
- a School of Medical & Health Sciences , Edith Cowan University , Perth , Australia
| | - Deborah Hersh
- a School of Medical & Health Sciences , Edith Cowan University , Perth , Australia
| | - Judith Katzenellebogen
- b University of Western Australia, Telethon Institute for Child Health Research , Perth , Australia
| | - Juli Coffin
- c Office of the Dean, University of Notre Dame , Broome , Australia
| | - Sandra Thompson
- d Western Australian Centre for Rural Health, University of Western Australia , Geraldton , Australia
| | - Leon Flicker
- e Western Australian Centre for Health & Ageing , Centre for Medical Research, University of Western Australia , Perth , Australia
| | - Colleen Hayward
- f Kurongkurl Katitjin, Centre for Indigenous Australian Education and Research, Edith Cowan University , Joondalup , Australia , and
| | - Deborah Woods
- g Geraldton Regional Aboriginal Medical Service , Geraldton , Austarlia
| | - Meaghan McAllister
- a School of Medical & Health Sciences , Edith Cowan University , Perth , Australia
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Lin IB, Coffin J, O'Sullivan PB. Using theory to improve low back pain care in Australian Aboriginal primary care: a mixed method single cohort pilot study. BMC Fam Pract 2016; 17:44. [PMID: 27068773 PMCID: PMC4828772 DOI: 10.1186/s12875-016-0441-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 03/24/2016] [Indexed: 12/02/2022]
Abstract
Background Low back pain (LBP) care is frequently discordant with research evidence. This pilot study evaluated changes in LBP care following a systematic, theory informed intervention in a rural Australian Aboriginal Health Service. We aimed to improve three aspects of care; reduce inappropriate LBP radiological imaging referrals, increase psychosocial oriented patient assessment and, increase the provision of LBP self-management information to patients. Methods Three interventions to improve care were developed using a four-step systematic implementation approach. A mixed methods pre/post cohort design evaluated changes in the three behaviours using a clinical audit of LBP care in a six month period prior to the intervention and then following implementation. In-depth interviews elicited the perspectives of involved General Practitioners (GPs). Qualitative analysis was guided by the theoretical domains framework. Results The proportion of patients who received guideline inconsistent imaging referrals (GICI) improved from 4.1 GICI per 10 patients to 0.4 (95 % CI for decrease in rate: 1.6 to 5.6) amongst GPs involved in the intervention. Amongst non-participating GPs (locum/part-time GPs who commenced post-interventions) the rate of GICI increased from 1.5 to 4.4 GICI per 10 patients (95 % CI for increase in rate: .5 to 5.3). There was a modest increase in the number of patients who received LBP self-management information from participating GPs and no substantial changes to psychosocial oriented patient assessments by any participants; however GPs qualitatively reported that their behaviours had changed. Knowledge and beliefs about consequences were important behavioural domains related to changes. Environmental and resource factors including protocols for locum staff and clinical tools embedded in patient management software were future strategies identified. Conclusions A systematic intervention model resulted in partial improvements in LBP care. Determinants of practice change amongst GPs were increased knowledge of clinical guidelines, education delivered by someone considered a trusted source of information, and awareness of the negative consequences of inappropriate practices, especially radiological imaging on patient outcomes. Inconsistent and non-evidence based practices amongst locum GPs was an issue that emerged and will be a significant future challenge. The systematic approach utilised is applicable to other services interested in improving LBP care.
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Affiliation(s)
- Ivan B Lin
- WA Centre for Rural Health, University of Western Australia, PO Box 109, Geraldton, 6531, Western Australia.
| | - Juli Coffin
- Geraldton Regional Aboriginal Medical Service, PO Box 4109, Rangeway, 6531, Western Australia.,Telethon Kids Institute, PO Box 855, West Perth, 6872, Western Australia
| | - Peter B O'Sullivan
- School of Physiotherapy, Curtin University, GPO Box U1987, Perth, 6845, Western Australia
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McAullay D, McAuley K, Marriott R, Pearson G, Jacoby P, Ferguson C, Geelhoed E, Coffin J, Green C, Sibosado S, Henry B, Doherty D, Edmond K. Improving access to primary care for Aboriginal babies in Western Australia: study protocol for a randomized controlled trial. Trials 2016; 17:82. [PMID: 26869181 PMCID: PMC4751713 DOI: 10.1186/s13063-016-1206-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 01/29/2016] [Indexed: 11/26/2022] Open
Abstract
Background Despite a decade of substantial investments in programs to improve access to primary care for Aboriginal mothers and infants, more than 50 % of Western Australian Aboriginal babies are still not receiving primary and preventative care in the early months of life. Western Australian hospitals now input birth data into the Western Australian electronic clinical management system within 48 hours of birth. However, difficulties have arisen in ensuring that the appropriate primary care providers receive birth notification and clinical information by the time babies are discharged from the hospital. No consistent process exists to ensure that choices about primary care are discussed with Aboriginal families. Methods/Design We will undertake a population-based, stepped wedge, cluster randomized controlled trial of an enhanced model of early infant primary care. The intervention is targeted support and care coordination for Aboriginal families with new babies starting as soon as possible during the antenatal period or after birth. Dedicated health professionals and research staff will consult with families about the families’ healthcare needs, provide information about healthcare in the first 3 months of life, offer assistance with birth and Medicare forms, consult with families about their choice for primary care provider, offer to notify the chosen primary care provider about the baby’s health needs, and offer assistance with healthcare coordination at the time of discharge from the hospital. We will evaluate this model of care using a rigorous stepped wedge approach. Our primary outcome measure is a reduced hospitalization rate in infants younger than 3 months of age. Secondary outcome measures include completed Aboriginal and Torres Strait Islander child health screening assessments, immunization coverage, and satisfaction of the families about early infant primary care. We will also assess the cost effectiveness of the model of care. Discussion This study will be conducted over a 4-year period in partnership with birthing hospitals and primary care providers including Western Australian Aboriginal Community Controlled Health Services and the new Primary Health Networks. The results of our trial will be used to develop improved primary care models and to improve health outcomes for all Aboriginal infants. These are vital steps toward more equitable health service delivery for the Aboriginal and Torres Strait Islander children in Australia. Trial Registration Australian New Zealand Clinical Trials Registry Registration number: ACTRN12615000976583 Date registered: 17 September 2015
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Affiliation(s)
- Daniel McAullay
- University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. .,Edith Cowen University, 2 Bradford St, Mount Lawley, WA, 6050, Australia.
| | - Kimberley McAuley
- University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - Rhonda Marriott
- Murdoch University, 90 South St, Murdoch, WA, 6150, Australia.
| | - Glenn Pearson
- Telethon Kids Institute, 100 Roberts Rd, Subiaco, WA, 6008, Australia.
| | - Peter Jacoby
- Telethon Kids Institute, 100 Roberts Rd, Subiaco, WA, 6008, Australia.
| | - Chantal Ferguson
- Western Australia Department of Health, 189 Royal Street, East Perth, WA, 6004, Australia.
| | - Elizabeth Geelhoed
- University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - Juli Coffin
- Geraldton Regional Aboriginal Medical Service, Holland St, Geraldton, WA, 6530, Australia.
| | - Charmaine Green
- University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. .,Geraldton Regional Aboriginal Medical Service, Holland St, Geraldton, WA, 6530, Australia.
| | - Selina Sibosado
- University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. .,Geraldton Regional Hospital, 51-85 Shenton St, Geraldton, WA, 6530, Australia.
| | - Barbara Henry
- Derbarl Yerrigan Aboriginal Medical Service, 156 Wittenoom St, East Perth, WA, 6004, Australia.
| | - Dorota Doherty
- University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. .,King Edward Memorial Hospital, 374 Bagot Rd, Subiaco, WA, 6008, Australia.
| | - Karen Edmond
- University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. .,Princess Margaret Hospital for Children, Roberts Rd, Subiaco, WA, 6008, Australia.
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Katzenellenbogen JM, Atkins ER, Thompson SC, Hersh D, Coffin J, Flicker L, Hayward C, Ciccone N, Woods D, McAllister M, Armstrong EM. Missing voices: Profile and extent of acquired communication disorders in Aboriginal and non-Aboriginal adult stroke survivors in Western Australia using linked administrative records. Int J Stroke 2015; 11:103-16. [DOI: 10.1177/1747493015607521] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Limited data exist on the extent of specific functional sequelae, including acquired communication disorder, among Aboriginal stroke survivors, making planning of multidisciplinary services difficult. Aims To obtain estimates of the extent and profile of acquired communication disorder in Aboriginal and non-Aboriginal adult stroke survivors in Western Australia and investigate potential disparities in receiving in-hospital speech pathology services among survivors with acquired communication disorder. Methods Stroke cases surviving their first stroke episode during 2002–2011 were identified using Western Australia-wide person-based linked hospital and mortality data, and their five-year comorbidity profiles determined. The mid-year prevalence of stroke cases with acquired communication disorder was estimated for 2011. Regression methods were used to investigate determinants of receiving speech pathology services among acquired communication disorder cases. Results Of 14,757 stroke survivors aged 15–79 years admitted in 2002–2011, 33% had acquired communication disorder (22% aphasia/dysphasia) and 777 (5.3%) were Aboriginal. Aboriginal patients were more likely to be younger, live remotely, and have comorbidities. A diagnosis of aphasia was more common in Aboriginal than non-Aboriginal patients 15–44 years (p = 0.003). A minimum of 107 Aboriginal and 2324 non-Aboriginal stroke patients with acquired communication disorder lived in Western Australia in 2011. Aboriginal status was not associated with receiving in-hospital speech services among acquired communication disorder patients in unadjusted or adjusted models. Conclusions The relative youth, geographical distribution, high comorbidity prevalence, and cultural needs of Aboriginal stroke patients with acquired communication disorder should inform appropriate service design for speech pathology and rehabilitation. Innovative models are required to address workforce issues, given low patient volumes.
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Affiliation(s)
- JM Katzenellenbogen
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Australia
| | - ER Atkins
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Australia
- The George Institute for Global Health, Sydney, Australia
| | - SC Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Australia
| | - D Hersh
- School of Psychology & Social Science, Edith Cowan University, Perth, Australia
| | - J Coffin
- Telethon Institute for Child Health Research, University of Western Australia, Perth, Australia
- Geraldton Regional Aboriginal Medical Service, Geraldton, Australia
| | - L Flicker
- Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia
| | - C Hayward
- Kurongkurl Katitjin, Centre for Indigenous Australian Education and Research, Edith Cowan University, Perth, Australia
| | - N Ciccone
- School of Psychology & Social Science, Edith Cowan University, Perth, Australia
| | - D Woods
- Geraldton Regional Aboriginal Medical Service, Geraldton, Australia
| | - M McAllister
- School of Psychology & Social Science, Edith Cowan University, Perth, Australia
| | - EM Armstrong
- School of Psychology & Social Science, Edith Cowan University, Perth, Australia
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Lin I, O'Sullivan P, Coffin J, Mak DB, Toussaint S, Straker L. 'I can sit and talk to her': Aboriginal people, chronic low back pain and healthcare practitioner communication. Aust Fam Physician 2014; 43:320-324. [PMID: 24791777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Chronic low back pain (CLBP) is a complex issue to manage in primary care and under-researched in Aboriginal populations. Good communication between practitioners and patients is essential but difficult to achieve. This study examined communication from the perspective of Aboriginal people with CLBP in regional and remote Western Australia. METHODS Qualitative, in-depth interviews were conducted with 32 adults with CLBP who identify as Aboriginal. The approach and analysis were informed by clinical ethnography and cultural security. RESULTS Barriers to communication related to communication content, information that was not evidence-based, miscommunications, communicative absence and the use of medical jargon. Enablers related to communication style described as 'yarning', a two-way dialogue, and healthcare practitioners with good listening and conversational skills. DISCUSSION Health practitioners need to consider communication content and style to improve interactions with Aboriginal people with CLBP. A 'yarning' style may be a useful framework. Findings may be pertinent to other populations.
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Affiliation(s)
- Ivan Lin
- BSc (Physiotherapy), MManip Ther, PhD, Assistant Professor, Western Australia Centre for Rural Health, University of Western Australia; and School of Physiotherapy, Curtin University, Perth, WA
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Skinner T, Blick J, Coffin J, Dudgeon P, Forrest S, Morrison D. Comparative validation of self-report measures of negative attitudes towards Aboriginal Australians and Torres Strait Islanders. Rural Remote Health 2013. [DOI: 10.22605/rrh1959] [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] Open
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Skinner TC, Blick J, Coffin J, Dudgeon P, Forrest S, Morrison D. Comparative validation of self-report measures of negative attitudes towards Aboriginal Australians and Torres Strait Islanders. Rural Remote Health 2013; 13:1959. [PMID: 23565853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION This study sought to determine the construct validity of two self-report measures of attitudes towards Aboriginal Australians and Torres Strait Islanders against an implicit measure of attitude. METHOD Total of 102 volunteer participants completed the three measures in a randomized order. The explicit measures of prejudice towards Aboriginal Australians were the Modern Racism Scale (MRS) and the Attitudes Towards Indigenous Australians Scale (ATIAS). The implicit attitudes measure was an adaptation of the Implicit Association Test (IAT) and utilised simple drawn head-and-shoulder images of Aboriginal Australians and White Australians as the stimuli. RESULTS Both explicit measures and implicit measure varied in the extent to which negative prejudicial attitudes were held by participants, and the corresponding construct validities were unimpressive. The MRS was significantly correlated with the IAT, (r =.314;p<.05) where the ATIAS was not significantly correlated with IAT scores (r =.12). CONCLUSION Of the two self-report measures of attitudes towards Aboriginal Australians, only the MRS evidenced validity when compared with the use of an implicit attitude measure.
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Affiliation(s)
- Timothy C Skinner
- Rural Clinical School, University of Tasmania, Burnie, Tasmania, Australia.
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Coffin J. Book review – Aboriginal Healthworkers; Primary health care at the margins. By Bill Genat with Sharon Bushby, May McGuire, Eileen Taylor, Yvette Wally, Thelma Weston. Health Promot J Austr 2009. [DOI: 10.1071/he09248] [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: 11/23/2022] Open
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Abstract
BACKGROUND Experience of interpersonal racism has been neglected as a mechanism by which inequalities between Aboriginal and non-Aboriginal people are created and maintained. METHODS Cross-sectional survey of randomly selected residents of a rural Australian town (n=639). Interpersonal racism was measured by two questions on experiences in the past four weeks of negative racially based treatment that evoked an emotional or physical response. Health was measured with the mental and physical health component scores of the Short-Form 12 and self-reported fair or poor general health. Linear and logistic regressions modelled the effects of interpersonal racism on health, controlling for age, sex, socio-economic status and Aboriginality. FINDINGS The 183 Aboriginal respondents had lower health component scores, were more than twice as likely to report fair-to-poor general health (34% compared with 17%, p<0.001), and 2.6 to 5.0 times more likely to report negative racially based treatment. Demographic and socio-economic characteristics were not associated with reporting negative racially based treatment. After controlling for other variables, Aboriginal respondents who reported negative treatment were more likely to have poor health on all three measures. Non-Aboriginal respondents who reported experiencing negative treatment had lower mental health component scores. IMPLICATIONS Experiencing racist treatment should be recognised as a social determinant of health. Improved health care and other initiatives may not eliminate health inequalities in the absence of fundamental changes in how non-Aboriginal people behave towards Aboriginal people.
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Affiliation(s)
- Ann Larson
- Combined Universities Centre for Rural Health, University of Western Australia.
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Coffin J. Our hope. Rural Remote Health 2007. [DOI: 10.22605/rrh825] [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] Open
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Palmer S, Boltz V, Martinson N, Maldarelli F, Gray G, McIntyre J, Mellors J, Morris L, Coffin J. Persistence of nevirapine-resistant HIV-1 in women after single-dose nevirapine therapy for prevention of maternal-to-fetal HIV-1 transmission. Proc Natl Acad Sci U S A 2006; 103:7094-9. [PMID: 16641095 PMCID: PMC1459023 DOI: 10.1073/pnas.0602033103] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Single-dose nevirapine (sdNVP) for prevention of mother-to-child transmission of HIV-1 can select nevirapine (NVP)-resistant variants, but the frequency, duration, and clinical significance of this resistance is not well defined. We used a sensitive allele-specific PCR assay to assess the emergence and persistence of NVP-resistant variants in plasma samples from 22 women with HIV-1 subtype C infection who participated in a study of sdNVP for prevention of mother-to-child transmission of HIV-1. The women were categorized into three groups on the basis of detection of NVP resistance by standard genotype analysis. Group 1 (n = 6) had NVP resistance detected at 2 and 6 mo after sdNVP, but not at 12 mo. Group 2 (n = 9) had NVP resistance detected at 2 mo, but not 6 mo. Group 3 (n = 7) had no NVP resistance detected at any time point. Allele-specific PCR analysis for the two most common NVP resistance mutations (K103N and Y181C) detected NVP-resistant variants in most (16 of 21) samples that were negative for NVP resistance by standard genotype, at levels ranging from 0.1% to 20% 1 yr after treatment. The frequency of NVP-resistant mutations decreased over time, but persisted above predose levels for more than 1 yr in > or = 23% of the women. These findings highlight the urgent need for studies assessing the impact of sdNVP on the efficacy of subsequent antiretroviral therapy containing NVP or other nonnucleoside reverse transcriptase inhibitors.
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Affiliation(s)
- S. Palmer
- *HIV Drug Resistance Program, National Cancer Institute, National Institutes of Health, Frederick, MD 21702-1201
| | - V. Boltz
- *HIV Drug Resistance Program, National Cancer Institute, National Institutes of Health, Frederick, MD 21702-1201
| | - N. Martinson
- Perinatal HIV Research Unit, University of the Witwatersrand, Diepkloof 1864, South Africa
- The Johns Hopkins University, Baltimore, MD 21209; and
| | - F. Maldarelli
- *HIV Drug Resistance Program, National Cancer Institute, National Institutes of Health, Frederick, MD 21702-1201
| | - G. Gray
- Perinatal HIV Research Unit, University of the Witwatersrand, Diepkloof 1864, South Africa
| | - J. McIntyre
- Perinatal HIV Research Unit, University of the Witwatersrand, Diepkloof 1864, South Africa
| | - J. Mellors
- University of Pittsburgh, Pittsburgh, PA 15260
| | - L. Morris
- National Institute for Communicable Diseases, Johannesburg 2131, South Africa
| | - J. Coffin
- *HIV Drug Resistance Program, National Cancer Institute, National Institutes of Health, Frederick, MD 21702-1201
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Coffin J, Latev M, Bi X, Nikiforov TT. Detection of phosphopeptides by fluorescence polarization in the presence of cationic polyamino acids: application to kinase assays. Anal Biochem 2000; 278:206-12. [PMID: 10660464 DOI: 10.1006/abio.1999.4438] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We have studied the interaction of several phosphopeptides with cationic polyamino acids such as polyarginine and polylysine by fluorescence polarization. The phosphopeptides used were labeled with fluorescein, and their net charges at the experimental pH of 7. 5 were 0, -1, -2, and -3. These phosphopeptides represent the products of enzymatic phosphorylation reactions of the corresponding nonphosphorylated precursors by the protein kinase A, Akt1 (protein kinase Balpha), and protein kinase C. We found that these phosphopeptides bind more strongly to the cationic polyamino acids studied than their nonphosphorylated analogs. This preferential binding of the phosphorylated peptides could be conveniently detected by an increase in the fluorescence polarization signal of the attached fluorescein residue. We have exploited this observation to develop a new approach for the detection of kinase activity that does not require radioactivity or separation of substrate from product. We have successfully used this method to perform K(m) determinations of the kinase enzymes for their substrates and K(i) determinations of one of their inhibitors. This method for measuring kinase activity might be particularly useful for high-throughput screening applications.
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Affiliation(s)
- J Coffin
- Caliper Technologies Corp., 605 Fairchild Drive, Mountain View, California 94043, USA
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