Research

9 pages, 557 KiB

Open AccessArticle

Cervical Screening Reminders for Aboriginal and Torres Strait Islander Women in Primary Care—Randomised Controlled Trial of Letter vs. Phone/SMS Reminders

by Rowena Ivers, Trish Levett and Kyla Wynn

Int. J. Environ. Res. Public Health 2023, 20(13), 6257; https://doi.org/10.3390/ijerph20136257 - 29 Jun 2023

Viewed by 1379

Abstract

(1) Background: Aboriginal women have a higher mortality from cervical cancer, yet cervical screening rates are lower than for other Australian women. (2) Methods: A randomised controlled trial of reminder letter vs. phone call/SMS for routine cervical screening testing in an Aboriginal Community [...] Read more.

(1) Background: Aboriginal women have a higher mortality from cervical cancer, yet cervical screening rates are lower than for other Australian women. (2) Methods: A randomised controlled trial of reminder letter vs. phone call/SMS for routine cervical screening testing in an Aboriginal Community Controlled Health Organisation in NSW. (3) Results: 256 women aged between 25 and 74 who were due for cervical screening were randomised to receive a reminder letter (and up to two further letters for non-responders) or a phone call (followed by up to two SMS) to attend the screening. A total of 15 women (12.5%) attended for cervical screening test within 3 months following a letter, and 24 women (17.6%) after a phone call/SMS reminder; this difference was not significant (p = 0.252). Time spent on sending letters vs. phone calls/SMS was similar; the cost was lowest for SMS. (4) Conclusion: Response to reminders was lower than expected. While there was no significant difference in effectiveness in letter vs. phone call/SMS for cervical screening recalls, reminder systems, including opportunistic reminders, can play a role in encouraging women to participate in screening programs in conjunction with national screening registers. The choice of reminder type should be left to service and consumer preference. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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31 pages, 3743 KiB

Open AccessArticle

Partnering with First Nations in Northern British Columbia Canada to Reduce Inequity in Access to Genomic Research

by Nadine R. Caron, Wilf Adam, Kate Anderson, Brooke T. Boswell, Meck Chongo, Viktor Deineko, Alexanne Dick, Shannon E. Hall, Jessica T. Hatcher, Patricia Howard, Megan Hunt, Kevin Linn and Ashling O’Neill

Int. J. Environ. Res. Public Health 2023, 20(10), 5783; https://doi.org/10.3390/ijerph20105783 - 10 May 2023

Viewed by 2311

Abstract

Indigenous-led, culturally safe health research and infrastructure are essential to address existing inequities and disparities for Indigenous Peoples globally. Biobanking, genomic research, and self-governance could reduce the existing divide and increase Indigenous participation in health research. While genomic research advances medicine, barriers persist [...] Read more.

Indigenous-led, culturally safe health research and infrastructure are essential to address existing inequities and disparities for Indigenous Peoples globally. Biobanking, genomic research, and self-governance could reduce the existing divide and increase Indigenous participation in health research. While genomic research advances medicine, barriers persist for Indigenous patients to benefit. In northern BC, Canada, the Northern Biobank Initiative (NBI), with guidance from a Northern First Nations Biobank Advisory Committee (NFNBAC), has engaged in consultations with First Nations on biobanking and genomic research. Key informant interviews and focus groups conducted with First Nations leaders, Elders, Knowledge Keepers, and community members established culturally safe ways of biobanking and exploring genomic research. Strong support for a Northern British Columbia First Nations Biobank (NBCFNB) that will promote choice, inclusion, and access to health research opportunities emerged. The acceptance and enthusiasm for the development of this NBCFNB and its governance table highlight the shift towards Indigenous ownership and support of health research and its benefits. With engagement and partnership, community awareness, multigenerational involvement, and support from diverse and experienced healthcare leaders, the NBCFNB will establish this culturally safe, locally driven, and critically important research priority that may serve as an example for diverse Indigenous groups when designing their unique biobanking or genomic research opportunities. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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18 pages, 385 KiB

Open AccessArticle

Enacting Mana Māori Motuhake during COVID-19 in Aotearoa (New Zealand): “We Weren’t Waiting to Be Told What to Do”

by Lynne Russell, Michelle Levy, Elizabeth Barnao, Nora Parore, Kirsten Smiler and Amohia Boulton

Int. J. Environ. Res. Public Health 2023, 20(8), 5581; https://doi.org/10.3390/ijerph20085581 - 19 Apr 2023

Viewed by 1896

Abstract

Māori, the Indigenous people of Aotearoa (New Zealand), were at the centre of their country’s internationally praised COVID-19 response. This paper, which presents the results of qualitative research conducted with 27 Māori health leaders exploring issues impacting the effective delivery of primary health [...] Read more.

Māori, the Indigenous people of Aotearoa (New Zealand), were at the centre of their country’s internationally praised COVID-19 response. This paper, which presents the results of qualitative research conducted with 27 Māori health leaders exploring issues impacting the effective delivery of primary health care services to Māori, reports this response. Against a backdrop of dominant system services closing their doors or reducing capacity, iwi, hapū and rōpū Māori (‘tribal’ collectives and Māori groups) immediately collectivised, to deliver culturally embedded, comprehensive COVID-19 responses that served the entire community. The results show how the exceptional and unprecedented circumstances of COVID-19 provided a unique opportunity for iwi, hapū and rōpū Māori to authentically activate mana motuhake; self-determination and control over one’s destiny. Underpinned by foundational principles of transformative Kaupapa Māori theory, Māori-led COVID-19 responses tangibly demonstrated the outcomes able to be achieved for everyone in Aotearoa when the wider, dominant system was forced to step aside, to be replaced instead with self-determining, collective, Indigenous leadership. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

25 pages, 728 KiB

Open AccessArticle

Development of an Australian FASD Indigenous Framework: Aboriginal Healing-Informed and Strengths-Based Ways of Knowing, Being and Doing

by Nicole Hewlett, Lorian Hayes, Robyn Williams, Sharynne Hamilton, Lorelle Holland, Alana Gall, Michael Doyle, Sarah Goldsbury, Nirosha Boaden and Natasha Reid

Int. J. Environ. Res. Public Health 2023, 20(6), 5215; https://doi.org/10.3390/ijerph20065215 - 22 Mar 2023

Cited by 5 | Viewed by 5368

Abstract

Aboriginal culture intuitively embodies and interconnects the threads of life that are known to be intrinsic to human wellbeing: connection. Therefore, Aboriginal wisdom and practices are inherently strengths-based and healing-informed. Underpinned by an Indigenist research methodology, this article presents findings from a collaboration [...] Read more.

Aboriginal culture intuitively embodies and interconnects the threads of life that are known to be intrinsic to human wellbeing: connection. Therefore, Aboriginal wisdom and practices are inherently strengths-based and healing-informed. Underpinned by an Indigenist research methodology, this article presents findings from a collaboration of Aboriginal and non-Aboriginal peoples to develop an Australian Fetal Alcohol Spectrum Disorder (FASD) Indigenous Framework during 2021 to 2023. The FASD Indigenous Framework unfolds the changes that non-Aboriginal clinicians and Aboriginal peoples each need to make in their respective ways of knowing, being and doing in order to facilitate access to healing-informed, strengths-based and culturally responsive FASD knowledge, assessment, diagnosis and support services among Aboriginal peoples. Drawing on the Aboriginal practices of yarning and Dadirri, written and oral knowledges were gathered. These knowledges were mapped against Aboriginal cultural responsiveness and wellbeing frameworks and collaboratively and iteratively reflected upon throughout. This article brings together Aboriginal wisdom (strengths-based, healing-informed approaches grounded in holistic and integrated support) and Western wisdom (biomedicine and therapeutic models) in relation to FASD. From a place of still awareness (Dadirri), both forms of wisdom were drawn upon to create Australia’s first FASD Indigenous Framework, a new practice in the assessment and diagnosis of FASD, which offers immense benefit to equity, justice, support and healing for Aboriginal families with a lived experience of FASD. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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19 pages, 751 KiB

Open AccessArticle

A Mixed Methods Study of 15 Years of Aboriginal Health Research in the Kimberley: ‘We’ve Been Researched, We Think, from Head to Toe, Inside and Outside, Upside Down’

by Allaneh Matsumoto, Kelly Blackburn, Billy Spicer, Kimberley Seear and Charmane Johnson

Int. J. Environ. Res. Public Health 2023, 20(6), 4823; https://doi.org/10.3390/ijerph20064823 - 09 Mar 2023

Viewed by 2104

Abstract

Indigenous peoples have long been the subjects of research, with the burden generally outweighing the benefit. This mixed methods study investigates the characteristics and outcomes of Aboriginal health research in the Kimberley region of Western Australia from 2006–2020 to inform future research practices. [...] Read more.

Indigenous peoples have long been the subjects of research, with the burden generally outweighing the benefit. This mixed methods study investigates the characteristics and outcomes of Aboriginal health research in the Kimberley region of Western Australia from 2006–2020 to inform future research practices. Quantitative data from projects submitted to the Kimberley Aboriginal Health Planning Forum Research Subcommittee were reviewed, and key characteristics were recorded and descriptively analysed. Fifteen individuals from a range of local organisations who were involved with research during this time participated in qualitative semi-structured interviews, including 11 Aboriginal people. The project team, including Aboriginal investigators, integrated quantitative and qualitative findings. Three major interview themes were questionable ‘research world’ behaviours; translation of findings and impact of research; and local involvement and control. The experiences of interviewees were congruent with quantitative data for the larger body of projects (N = 230). Most projects (60%) were not initiated within the Kimberley, with positive impact for local communities often not clear. There were, however, examples of Kimberley Aboriginal-led research excellence. A way forward includes research that is developed, driven, and led by the community; alignment with research priorities; local Aboriginal involvement that is resourced and acknowledged; and comprehensive knowledge translation plans embedded in projects. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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24 pages, 1714 KiB

Open AccessArticle

Don’t Follow the Smoke—Listening to the Tobacco Experiences and Attitudes of Urban Aboriginal Adolescents in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH)

by Christina L. Heris, Mandy Cutmore, Catherine Chamberlain, Natalie Smith, Victor Simpson, Simone Sherriff, Darryl Wright, Kym Slater and Sandra Eades

Int. J. Environ. Res. Public Health 2023, 20(5), 4587; https://doi.org/10.3390/ijerph20054587 - 04 Mar 2023

Viewed by 2277

Abstract

Preventing smoking among young Aboriginal people is important for reducing health inequities. Multiple factors were associated with adolescent smoking in the SEARCH baseline survey (2009–12) and discussed in a follow-up qualitative study that aimed to inform prevention programs. Twelve yarning circles were facilitated [...] Read more.

Preventing smoking among young Aboriginal people is important for reducing health inequities. Multiple factors were associated with adolescent smoking in the SEARCH baseline survey (2009–12) and discussed in a follow-up qualitative study that aimed to inform prevention programs. Twelve yarning circles were facilitated by Aboriginal research staff at two NSW sites in 2019 with 32 existing SEARCH participants aged 12–28 (17 female, 15 male). Open discussion around tobacco was followed by a card sorting activity, prioritising risk and protective factors and program ideas. The age of initiation varied by generation. Older participants had established smoking in their early adolescence, whereas the current younger teens had little exposure. Some smoking commenced around high school (from Year 7), and social smoking increased at age 18. Mental and physical health, smoke-free spaces and strong connections to family, community and culture promoted non-smoking. The key themes were (1) drawing strength from culture and community; (2) how the smoking environment shapes attitudes and intentions; (3) non-smoking as a sign of good physical, social and emotional wellbeing; and (4) the importance of individual empowerment and engagement for being smoke-free. Programs promoting good mental health and strengthening cultural and community connections were identified as a priority for prevention. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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21 pages, 1006 KiB

Open AccessArticle

Exploring Indigenous Community Conceptions of Parent Wellbeing: A Qualitative Analysis

by Arvind Ponnapalli, Tarita Fisher and Karen M. T. Turner

Int. J. Environ. Res. Public Health 2023, 20(4), 3585; https://doi.org/10.3390/ijerph20043585 - 17 Feb 2023

Cited by 1 | Viewed by 1867

Abstract

Using non-Indigenous perspectives of parental social and emotional wellbeing in the design and application of parent support programs can undermine program effectiveness as it may not account for Indigenous family structures and community values. With a clearer understanding of Indigenous parent wellbeing and [...] Read more.

Using non-Indigenous perspectives of parental social and emotional wellbeing in the design and application of parent support programs can undermine program effectiveness as it may not account for Indigenous family structures and community values. With a clearer understanding of Indigenous parent wellbeing and its determinants, parenting interventions can be more appropriately designed and tailored to provide support for Indigenous families. This study utilised a community-based participatory action research approach involving collaboration between the research team, participants, and community advisory groups to explore Indigenous parents’ and carers’ conceptions of wellbeing. Participants’ cultural perspectives on parent wellbeing were collected through semi-structured focus groups and in-depth interviews (N = 20). Thematic analysis was undertaken using theory-driven and interpretative phenomenological analysis. Eleven themes emerged as risk and protective factors across three domains: child domain (i.e., school attendance and education, respect, routine, development), parent domain (i.e., role modelling, self-regulation of body, self-regulation of mind and emotions, parenting strategies), and context domain (i.e., connections to family and kinship, community, access to services). It is noteworthy that parents reported three super-ordinate intersecting themes across all domains: connection to culture, Country, and spirituality. In addition, Indigenous parents’ and carers’ conception of their own wellbeing is closely linked to their children’s wellbeing, their lived community context, and expected personal indicators. In recognising and working with this holistic view of Indigenous parent wellbeing, parent support programs can be optimally designed and implemented in Indigenous communities. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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14 pages, 329 KiB

Open AccessArticle

Communities Setting the Direction for Their Right to Nutritious, Affordable Food: Co-Design of the Remote Food Security Project in Australian Indigenous Communities

by Megan Ferguson, Emma Tonkin, Julie Brimblecombe, Amanda Lee, Bronwyn Fredericks, Katherine Cullerton, Catherine L. Mah, Clare Brown, Emma McMahon, Mark D. Chatfield, Eddie Miles and Yvonne Cadet-James

Int. J. Environ. Res. Public Health 2023, 20(4), 2936; https://doi.org/10.3390/ijerph20042936 - 08 Feb 2023

Cited by 4 | Viewed by 3008

Abstract

Despite long histories of traditional food security, Indigenous peoples globally are disproportionately exposed to food insecurity. Addressing this imbalance must be a partnership led by Indigenous peoples in accordance with the UN Declaration of the Rights of Indigenous Peoples. We report the co-design [...] Read more.

Despite long histories of traditional food security, Indigenous peoples globally are disproportionately exposed to food insecurity. Addressing this imbalance must be a partnership led by Indigenous peoples in accordance with the UN Declaration of the Rights of Indigenous Peoples. We report the co-design process and resulting design of a food security research project in remote Australia and examine how the co-design process considered Indigenous peoples’ ways of knowing, being, and doing using the CREATE Tool. Informed by the Research for Impact Tool, together Aboriginal Community Controlled Health Organisation staff, Indigenous and non-Indigenous public health researchers designed the project from 2018–2019, over a series of workshops and through the establishment of research advisory groups. The resulting Remote Food Security Project includes two phases. Phase 1 determines the impact of a healthy food price discount strategy on the diet quality of women and children, and the experience of food (in)security in remote communities in Australia. In Phase 2, community members propose solutions to improve food security and develop a translation plan. Examination with the CREATE Tool showed that employing a co-design process guided by a best practice tool has resulted in a research design that responds to calls for food security in remote Indigenous communities in Australia. The design takes a strengths-based approach consistent with a human rights, social justice, and broader empowerment agenda. Trial registration: The trial included in Phase 1 of this project has been registered with Australian New Zealand Clinical Trials Registry: ACTRN12621000640808. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

11 pages, 298 KiB

Open AccessArticle

Aboriginal Young People’s Experiences of Accessibility in Mental Health Services in Two Regions of New South Wales, Australia

by Jasper Garay, Anna Williamson, Christian Young, Janice Nixon, Mandy Cutmore, Simone Sherriff, Natalie Smith, Kym Slater and Michelle Dickson

Int. J. Environ. Res. Public Health 2023, 20(3), 1730; https://doi.org/10.3390/ijerph20031730 - 18 Jan 2023

Cited by 1 | Viewed by 2336

Abstract

This article assesses the accessibility of mainstream mental health services (MMHSs) in two regions of New South Wales (NSW), Australia, based on experiences and perspectives of Aboriginal young people aged 16–25. Semi-structured yarning interviews were conducted with thirteen Aboriginal young people in two [...] Read more.

This article assesses the accessibility of mainstream mental health services (MMHSs) in two regions of New South Wales (NSW), Australia, based on experiences and perspectives of Aboriginal young people aged 16–25. Semi-structured yarning interviews were conducted with thirteen Aboriginal young people in two regions of NSW. Thematic analysis was undertaken by all research team members to identify major themes from the data and conceptual connections between them. The identified themes from individual analysis and coding were triangulated during several analysis meetings to finalise the key themes and findings. Aboriginal young people had no experience of engaging with early-intervention MMHSs. MMHSs were identified as inaccessible, with most participants unaware that MMHSs existed in each region. Due to MMHSs being inaccessible, many Aboriginal young people presented to emergency departments (EDs) during a crisis. Aboriginal Community Controlled Health Services (ACCHSs) were identified as key providers of accessible, culturally meaningful, and effective social and emotional wellbeing (SEWB) service support for Aboriginal young people in NSW. If health and wellbeing outcomes are to improve for Aboriginal young people in NSW, MMHSs must increase accessibility for Aboriginal young people requiring SEWB support. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

19 pages, 767 KiB

Open AccessArticle

The Availability, Appropriateness, and Integration of Services to Promote Indigenous Australian Youth Wellbeing and Mental Health: Indigenous Youth and Service Provider Perspectives

by Janya Robyn McCalman, Ruth Fagan, Tina McDonald, Semara Jose, Paul Neal, Ilse Blignault, Deborah Askew and Yvonne Cadet-James

Int. J. Environ. Res. Public Health 2023, 20(1), 375; https://doi.org/10.3390/ijerph20010375 - 26 Dec 2022

Cited by 4 | Viewed by 2652

Abstract

Concerns about the complexity, fragmentation and inefficiency of Australia’s current youth mental health service systems have led policy makers to seek improvements through a shift to community-based solutions. However, there is little evidence of how communities can make this shift. This paper examines [...] Read more.

Concerns about the complexity, fragmentation and inefficiency of Australia’s current youth mental health service systems have led policy makers to seek improvements through a shift to community-based solutions. However, there is little evidence of how communities can make this shift. This paper examines the efforts of one Aboriginal and Torres Strait Islander (hereafter, respectfully, Indigenous) community—Yarrabah in north Queensland—to develop strategies for mental health and wellbeing service system improvements for school-aged youth (5–18 years). The research was co-designed with Yarrabah’s community-controlled health service and explores the perceptions of Yarrabah youth and service providers. Iterative grounded theory methods were used to collect and analyse data from 32 youth aged 11–24 years and 24 service providers. Youth were reluctant to seek help, and did so only if they felt a sense of safety, trust, relationality and consistency with providers. Young people’s four suggestions for improvement were access to (1) information and awareness about mental health; (2) youth facilities, spaces and activities; (3) safe and available points of contact; and (4) support for recovery from mental illness. Service providers highlighted an appetite for youth-guided community change and recommended five improvement strategies: (1) listening to youth, (2) linking with community members, (3) providing wellbeing promotion programs, (4) intervening early, and (5) advocating to address the determinants of youth mental health. Overall, both groups realised a disjunct between youth need and service provision, but a willingness to work together for systems change. This study demonstrates the importance of community-driven efforts that harness both youth and service providers’ perspectives, and suggests a need for ongoing dialogue as the basis for co-designing and implementing improvements to wellbeing supports and mental health services for Indigenous youth. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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15 pages, 797 KiB

Open AccessArticle

VOICE–Validating Outcomes by Including Consumer Experience: A Study Protocol to Develop a Patient Reported Experience Measure for Aboriginal and Torres Strait Islander Peoples Accessing Primary Health Care

by Amal Chakraborty, Emma Walke, Roxanne Bainbridge, Ross Bailie, Veronica Matthews, Sarah Larkins, Paul Burgess, Deborah Askew, Erika Langham, Samantha Smorgon, Girish Swaminathan, Danielle Cameron, Tracey Piccoli and Megan Passey

Int. J. Environ. Res. Public Health 2023, 20(1), 357; https://doi.org/10.3390/ijerph20010357 - 26 Dec 2022

Cited by 1 | Viewed by 3103

Abstract

Aboriginal and Torres Strait Islander peoples’ (hereafter respectfully referred to as Indigenous Australians) experiences of health care are shaped by historical, social and cultural factors, with cultural security critical to effective care provision and engagement between services and community. Positive patient experiences are [...] Read more.

Aboriginal and Torres Strait Islander peoples’ (hereafter respectfully referred to as Indigenous Australians) experiences of health care are shaped by historical, social and cultural factors, with cultural security critical to effective care provision and engagement between services and community. Positive patient experiences are associated with better health outcomes. Consequently, it is an accreditation requirement that primary health care (PHC) services must formally gather and respond to patient feedback. However, currently available patient feedback tools were not developed with Indigenous Australians, and do not reflect their values and world views. Existing tools do not capture important experiences of care of Indigenous Australians in PHC settings, nor return information that assists services to improve care. Consistent with the principles of Indigenous Data Sovereignty, we will co-design and validate an Indigenous-specific Patient Reported Experience Measure (PREM) that produces data by and for community, suitable for use in quality improvement in comprehensive PHC services. This paper presents the protocol of the study, outlining the rationale, methodologies and associated activities that are being applied in developing the PREM. Briefly, guided by an Aboriginal and Torres Strait Islander Advisory Group, our team of Indigenous and non-Indigenous researchers, service providers and policy makers will use a combination of Indigenous methodologies, participatory, and traditional western techniques for scale development. We will engage PHC service staff and communities in eight selected sites across remote, regional, and metropolitan communities in Australia for iterative cycles of data collection and feedback throughout the research process. Yarning Circles with community members will identify core concepts to develop an “Experience of Care Framework”, which will be used to develop items for the PREM. Staff members will be interviewed regarding desirable characteristics and feasibility considerations for the PREM. The PREM will undergo cognitive and psychometric testing. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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19 pages, 468 KiB

Open AccessArticle

Development of Key Principles and Best Practices for Co-Design in Health with First Nations Australians

by Kate Anderson, Alana Gall, Tamara Butler, Khwanruethai Ngampromwongse, Debra Hector, Scott Turnbull, Kerri Lucas, Caroline Nehill, Anna Boltong, Dorothy Keefe and Gail Garvey

Int. J. Environ. Res. Public Health 2023, 20(1), 147; https://doi.org/10.3390/ijerph20010147 - 22 Dec 2022

Cited by 9 | Viewed by 4654

Abstract

Background: While co-design offers potential for equitably engaging First Nations Australians in findings solutions to redressing prevailing disparities, appropriate applications of co-design must align with First Nations Australians’ culture, values, and worldviews. To achieve this, robust, culturally grounded, and First Nations-determined principles and [...] Read more.

Background: While co-design offers potential for equitably engaging First Nations Australians in findings solutions to redressing prevailing disparities, appropriate applications of co-design must align with First Nations Australians’ culture, values, and worldviews. To achieve this, robust, culturally grounded, and First Nations-determined principles and practices to guide co-design approaches are required. Aims: This project aimed to develop a set of key principles and best practices for co-design in health with First Nations Australians. Methods: A First Nations Australian co-led team conducted a series of Online Yarning Circles (OYC) and individual Yarns with key stakeholders to guide development of key principles and best practice approaches for co-design with First Nations Australians. The Yarns were informed by the findings of a recently conducted comprehensive review, and a Collaborative Yarning Methodology was used to iteratively develop the principles and practices. Results: A total of 25 stakeholders participated in the Yarns, with 72% identifying as First Nations Australian. Analysis led to a set of six key principles and twenty-seven associated best practices for co-design in health with First Nations Australians. The principles were: First Nations leadership; Culturally grounded approach; Respect; Benefit to community; Inclusive partnerships; and Transparency and evaluation. Conclusions: Together, these principles and practices provide a valuable starting point for the future development of guidelines, toolkits, reporting standards, and evaluation criteria to guide applications of co-design with First Nations Australians. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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17 pages, 623 KiB

Open AccessArticle

Cultural Proficiency in First Nations Health Research: A Mixed-Methods, Cross-Cultural Evaluation of a Novel Resource

by Paul Saunders and Aunty Kerrie Doyle

Int. J. Environ. Res. Public Health 2023, 20(1), 39; https://doi.org/10.3390/ijerph20010039 - 20 Dec 2022

Cited by 1 | Viewed by 1698

Abstract

Recent efforts have illustrated the efficacy of culturally proficient approaches to research, underpinned by robust partnerships between researchers and First Nations peoples and communities. This article seeks to determine differences in approaches to First Nations research engagement perceptions between First Nations and non-First [...] Read more.

Recent efforts have illustrated the efficacy of culturally proficient approaches to research, underpinned by robust partnerships between researchers and First Nations peoples and communities. This article seeks to determine differences in approaches to First Nations research engagement perceptions between First Nations and non-First Nations researchers, as well as whether participation in a cultural proficiency workshop improved the perceived cultural proficiency of non-First Nations health researchers. Also, whether a set of novel cultural proficiency resources, designed in the Sydney region could be applied broadly across First Nations contexts within Australia. The evaluation adopted a mixed-methods, cross-cultural (First Nations and non-First Nations) design to appraise the novel cultural proficiency resources, identifying participant perceptions to First Nations research engagement, as well as views regarding the feasibility of universal application of the resources. A quantitative pre- and post-workshop evaluation was also undertaken to measure differences in self-reported cultural proficiency. Qualitative data underwent thematic analysis and quantitative data were analysed applying t-tests. Both qualitative and quantitative evaluation showed minimal variation between the cultural groups regarding research engagement perceptions, based on viewing of the online resources. A statistically significant increase in self-reported cultural proficiency was found in non-First Nations workshop participants. Cultural proficiency education and training programs that promote an immersive, interactive, and ongoing framework can build the perceived cultural proficiency of non-First Nations health researchers, however First Nations expertise must validate this perceived cultural proficiency to be beneficial in practice. Based on the research findings, applying the underlying ethical principles of First Nations research with a local, context-centred approach allows for the broad application of cultural proficiency research education and training programs within Australia. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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11 pages, 352 KiB

Open AccessArticle

Community-Led Health Initiatives for Torres Straits Island Communities in a Changing Climate: Implementing Core Values for Mitigation and Adaptation

by Nina Lansbury, Andrew M. Redmond and Francis Nona

Int. J. Environ. Res. Public Health 2022, 19(24), 16574; https://doi.org/10.3390/ijerph192416574 - 09 Dec 2022

Cited by 1 | Viewed by 1975

Abstract

First Nations Peoples have a long history of living in Australia’s changing climate and a deep knowledge of their traditional estate (‘Country’). However, human-induced climate change raises unforeseen risks to the health of First Nations Peoples—especially in remotely located communities. This includes the [...] Read more.

First Nations Peoples have a long history of living in Australia’s changing climate and a deep knowledge of their traditional estate (‘Country’). However, human-induced climate change raises unforeseen risks to the health of First Nations Peoples—especially in remotely located communities. This includes the Torres Strait Islands, where a local leader asked our Torres Strait Islander co-author, ’We know that you will return to your Country—unlike previous researchers. So how can you help with climate change?’ In response, this research describes four core values focused on supporting First Nations Peoples’ health and wellbeing: co-design, appropriate governance, support for self-determination, and respectfully incorporating Indigenous Knowledges into health-protective climate initiatives. Supporting the health and wellbeing of Torres Strait Islanders to continue living in the remote Torres Strait Islands in a changing climate can enable long-term care for Country, maintenance of culture, and a sense of identity for First Nations Peoples. Ensuring these core values are implemented can support the health of present and future generations and will likely be applicable to other First Nations communities. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

14 pages, 914 KiB

Open AccessArticle

Experiences of Older Aboriginal People in Navigating Transport Systems in an Urban Setting: An Indigenous Perspective on Transport Access, a Social Determinant of Health

by Tracey Ma, Rebecca Ivers, John Solar, Aaron Simon, Evelyne de Leeuw and Kathleen Clapham

Int. J. Environ. Res. Public Health 2022, 19(21), 13778; https://doi.org/10.3390/ijerph192113778 - 23 Oct 2022

Cited by 1 | Viewed by 2449

Abstract

Background: In Australia, Aboriginal people are underserved by the transport system and are less able to easily get to places they need to go than others. This is a part of a larger pattern of exclusion and inequity for Aboriginal people which affects [...] Read more.

Background: In Australia, Aboriginal people are underserved by the transport system and are less able to easily get to places they need to go than others. This is a part of a larger pattern of exclusion and inequity for Aboriginal people which affects their health, wellbeing, and social participation. Guided by a decolonising framework, this research explored how older Aboriginal people, whose pivotal roles in their families and communities require their mobility, experience the transportation system, providing an Indigenous-centred view of the accessibility of transportation options in society. Methods: Interviews drawing from the yarning technique were conducted with ten older Aboriginal people living in Greater Western Sydney and analysed qualitatively. Results: In addition to the cognitive labour required to decipher the rules of the transport system and organise commitments to match the scheduling of transport services, older Aboriginal people in this study experienced stigmatising attitudes and condescending treatment from service professionals and the public when traveling. Conclusions: This study suggests three potential ways that the current trajectory that underserves older Aboriginal people could be disrupted, relating to service design, the diversity and inclusion agenda, and the social determinants of Indigenous health. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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15 pages, 1335 KiB

Open AccessArticle

Concerted Model of Healthcare for Awá Indigenous of Nariño, Colombia

by Harold Mauricio Casas Cruz, Blanca Estela Pelcastre-Villafuerte, Luz Arenas-Monreal and Myriam Ruiz-Rodríguez

Int. J. Environ. Res. Public Health 2022, 19(19), 12250; https://doi.org/10.3390/ijerph191912250 - 27 Sep 2022

Viewed by 1595

Abstract

Indigenous communities in Colombia are facing a critical health situation; alternative health care models based on the vision of the communities themselves are needed. The objective of this research was to create a health care model that decreases health inequities for the Indigenous [...] Read more.

Indigenous communities in Colombia are facing a critical health situation; alternative health care models based on the vision of the communities themselves are needed. The objective of this research was to create a health care model that decreases health inequities for the Indigenous Awá population of Nariño, Colombia. This study was guided by the paradigm of community-based participatory action research; the process was carried out in 2015 and 2016. The proposed Intercultural Health Care Model is essentially based on health promotion, disease prevention, community empowerment, social participation in health, decentralized health care and coordination between the two medicines (traditional and allopathic). Strategies such as those reported herein, with concerted efforts rather than imposition, maintain human rights and respect for the sovereignty and autonomy of Indigenous people. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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20 pages, 4082 KiB

Open AccessArticle

Capturing Household Structure and Mobility within and between Remote Aboriginal Communities in Northern Australia Using Longitudinal Data: A Pilot Study

by Jessie J. Goldsmith, Patricia T. Campbell, Juan Pablo Villanueva-Cabezas, Rebecca H. Chisholm, Melita McKinnon, George G. Gurruwiwi, Roslyn G. Dhurrkay, Alfred M. Dockery, Nicholas Geard, Steven Y. C. Tong, Jodie McVernon and Katherine B. Gibney

Int. J. Environ. Res. Public Health 2022, 19(19), 12002; https://doi.org/10.3390/ijerph191912002 - 22 Sep 2022

Viewed by 1649

Abstract

Cultural practices and development level can influence a population’s household structures and mixing patterns. Within some populations, households can be organized across multiple dwellings. This likely affects the spread of infectious disease through these communities; however, current demographic data collection tools do not [...] Read more.

Cultural practices and development level can influence a population’s household structures and mixing patterns. Within some populations, households can be organized across multiple dwellings. This likely affects the spread of infectious disease through these communities; however, current demographic data collection tools do not record these data. Methods: Between June and October 2018, the Contact And Mobility Patterns in remote Aboriginal Australian communities (CAMP-remote) pilot study recruited Aboriginal mothers with infants in a remote northern Australian community to complete a monthly iPad-based contact survey. Results: Thirteen mother–infant pairs (participants) completed 69 study visits between recruitment and the end of May 2019. Participants reported they and their other children slept in 28 dwellings during the study. The median dwelling occupancy, defined as people sleeping in the same dwelling on the previous night, was ten (range: 3.5–25). Participants who completed at least three responses (n = 8) slept in a median of three dwellings (range: 2–9). Each month, a median of 28% (range: 0–63%) of the participants travelled out of the community. Including these data in disease transmission models amplified estimates of infectious disease spread in the study community, compared to models parameterized using census data. Conclusions: The lack of data on mixing patterns in populations where households can be organized across dwellings may impact the accuracy of infectious disease models for these communities and the efficacy of public health actions they inform. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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14 pages, 363 KiB

Open AccessArticle

Built Environment Features and Cardiometabolic Mortality and Morbidity in Remote Indigenous Communities in the Northern Territory, Australia

by Amal Chakraborty, Margaret Cargo, Victor Maduabuchi Oguoma, Neil T. Coffee, Alwin Chong and Mark Daniel

Int. J. Environ. Res. Public Health 2022, 19(15), 9435; https://doi.org/10.3390/ijerph19159435 - 01 Aug 2022

Cited by 1 | Viewed by 1834

Abstract

Indigenous Australians experience poorer health than non-Indigenous Australians, with cardiometabolic diseases (CMD) being the leading causes of morbidity and mortality. Built environmental (BE) features are known to shape cardiometabolic health in urban contexts, yet little research has assessed such relationships for remote-dwelling Indigenous [...] Read more.

Indigenous Australians experience poorer health than non-Indigenous Australians, with cardiometabolic diseases (CMD) being the leading causes of morbidity and mortality. Built environmental (BE) features are known to shape cardiometabolic health in urban contexts, yet little research has assessed such relationships for remote-dwelling Indigenous Australians. This study assessed associations between BE features and CMD-related morbidity and mortality in a large sample of remote Indigenous Australian communities in the Northern Territory (NT). CMD-related morbidity and mortality data were extracted from NT government health databases for 120 remote Indigenous Australian communities for the period 1 January 2010 to 31 December 2015. BE features were extracted from Serviced Land Availability Programme (SLAP) maps. Associations were estimated using negative binomial regression analysis. Univariable analysis revealed protective effects on all-cause mortality for the BE features of Education, Health, Disused Buildings, and Oval, and on CMD-related emergency department admissions for the BE feature Accommodation. Incidence rate ratios (IRR’s) were greater, however, for the BE features Infrastructure Transport and Infrastructure Shelter. Geographic Isolation was associated with elevated mortality-related IRR’s. Multivariable regression did not yield consistent associations between BE features and CMD outcomes, other than negative relationships for Indigenous Location-level median age and Geographic Isolation. This study indicates that relationships between BE features and health outcomes in urban populations do not extend to remote Indigenous Australian communities. This may reflect an overwhelming impact of broader social inequity, limited correspondence of BE measures with remote-dwelling Indigenous contexts, or a ‘tipping point’ of collective BE influences affecting health more than singular BE features. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

Review

Jump to: Research, Other

20 pages, 444 KiB

Open AccessReview

From Deficit to Strength-Based Aboriginal Health Research—Moving toward Flourishing

by Jonathan Bullen, Trish Hill-Wall, Kate Anderson, Alex Brown, Clint Bracknell, Elizabeth A. Newnham, Gail Garvey and Lea Waters

Int. J. Environ. Res. Public Health 2023, 20(7), 5395; https://doi.org/10.3390/ijerph20075395 - 04 Apr 2023

Cited by 8 | Viewed by 4462

Abstract

Aboriginal Australians have a fundamental human right to opportunities that lead to healthy and flourishing lives. While the impact of trauma on Aboriginal Australians is well-documented, a pervasive deficit narrative that focuses on problems and pathology persists in research and policy discourse. This [...] Read more.

Aboriginal Australians have a fundamental human right to opportunities that lead to healthy and flourishing lives. While the impact of trauma on Aboriginal Australians is well-documented, a pervasive deficit narrative that focuses on problems and pathology persists in research and policy discourse. This narrative risks further exacerbating Aboriginal disadvantage through a focus on ‘fixing what is wrong’ with Aboriginal Australians and the internalising of these narratives by Aboriginal Australians. While a growing body of research adopts strength-based models, limited research has sought to explore Aboriginal flourishing. This conceptual paper seeks to contribute to a burgeoning paradigm shift in Aboriginal research, seeking to understand what can be learned from Aboriginal people who flourish, how we best determine this, and in what contexts this can be impactful. Within, we argue the case for a new approach to exploring Aboriginal wellbeing that integrates salutogenic, positive psychology concepts with complex systems theory to understand and promote Aboriginal wellbeing and flourishing. While deeper work may be required to establish the parameters of a strength-based, culturally aligned Aboriginal conceptualisation of positive psychology, we suggest the integration of Aboriginal and Western methodologies offers a unique and potent means of shifting the dial on seemingly intractable problems. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

21 pages, 768 KiB

Open AccessReview

Exploring the Reported Strengths and Limitations of Aboriginal and Torres Strait Islander Health Research: A Narrative Review of Intervention Studies

by Romany McGuffog, Jamie Bryant, Kade Booth, Felicity Collis, Alex Brown, Jaquelyne T. Hughes, Catherine Chamberlain, Alexandra McGhie, Breanne Hobden and Michelle Kennedy

Int. J. Environ. Res. Public Health 2023, 20(5), 3993; https://doi.org/10.3390/ijerph20053993 - 23 Feb 2023

Cited by 3 | Viewed by 3885

Abstract

High quality intervention research is needed to inform evidence-based practice and policy for Aboriginal and Torres Strait Islander communities. We searched for studies published from 2008–2020 in the PubMed database. A narrative review of intervention literature was conducted, where we identified researcher reported [...] Read more.

High quality intervention research is needed to inform evidence-based practice and policy for Aboriginal and Torres Strait Islander communities. We searched for studies published from 2008–2020 in the PubMed database. A narrative review of intervention literature was conducted, where we identified researcher reported strengths and limitations of their research practice. A total of 240 studies met inclusion criteria which were categorised as evaluations, trials, pilot interventions or implementation studies. Reported strengths included community engagement and partnerships; sample qualities; Aboriginal and Torres Strait Islander involvement in research; culturally appropriate and safe research practice; capacity building efforts; providing resources or reducing costs for services and communities; understanding local culture and context; and appropriate timelines for completion. Reported limitations included difficulties achieving the target sample size; inadequate time; insufficient funding and resources; limited capacity of health workers and services; and inadequate community involvement and communication issues. This review highlights that community consultation and leadership coupled with appropriate time and funding, enables Aboriginal and Torres Strait Islander health intervention research to be conducted. These factors can enable effective intervention research, and consequently can help improve health and wellbeing outcomes for Aboriginal and Torres Strait Islander people. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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44 pages, 1138 KiB

Open AccessReview

Aspects of Wellbeing for Indigenous Youth in CANZUS Countries: A Systematic Review

by Kate Anderson, Elaina Elder-Robinson, Alana Gall, Khwanruethai Ngampromwongse, Michele Connolly, Angeline Letendre, Esther Willing, Zaine Akuhata-Huntington, Kirsten Howard, Michelle Dickson and Gail Garvey

Int. J. Environ. Res. Public Health 2022, 19(20), 13688; https://doi.org/10.3390/ijerph192013688 - 21 Oct 2022

Cited by 4 | Viewed by 3212

Abstract

Indigenous children and young people (hereafter youth) across CANZUS nations embody a rich diversity of cultures and traditions. Despite the immense challenges facing these youth, many harness cultural and personal strengths to protect and promote their wellbeing. To support this for all youth, [...] Read more.

Indigenous children and young people (hereafter youth) across CANZUS nations embody a rich diversity of cultures and traditions. Despite the immense challenges facing these youth, many harness cultural and personal strengths to protect and promote their wellbeing. To support this for all youth, it is critical to understand what contributes to their wellbeing. This review aims to identify components contributing to wellbeing for Indigenous youth in CANZUS nations. Five databases were searched from inception to August 2022. Papers were eligible if they: focused on Indigenous youth in CANZUS nations; included views of youth or proxies; and focused on at least one aspect of wellbeing. We identified 105 articles for inclusion (Canada n = 42, Australia n = 27, Aotearoa New Zealand n = 8, USA n = 28) and our analysis revealed a range of thematic areas within each nation that impact wellbeing for Indigenous youth. Findings highlight the unique challenges facing Indigenous youth, as well as their immense capacity to harness cultural and personal strengths to navigate into an uncertain future. The commonalities of Indigenous youth wellbeing across these nations provide valuable insights into how information and approaches can be shared across borders to the benefit of all Indigenous youth and future generations. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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13 pages, 402 KiB

Open AccessReview

Community Engagement and Psychometric Methods in Aboriginal and Torres Strait Islander Patient-Reported Outcome Measures and Surveys—A Scoping Review and Critical Analysis

by Courtney Ryder, Jacqueline H. Stephens, Shahid Ullah, Julieann Coombes, Nayia Cominos, Patrick Sharpe, Shane D’Angelo, Darryl Cameron, Colleen Hayes, Keziah Bennett-Brook and Tamara Mackean

Int. J. Environ. Res. Public Health 2022, 19(16), 10354; https://doi.org/10.3390/ijerph191610354 - 19 Aug 2022

Cited by 1 | Viewed by 2140

Abstract

(1) Background: In healthcare settings, patient-reported outcome measures (PROMs) and surveys are accepted, patient-centered measures that provide qualitative information on dimensions of health and wellbeing. The level of psychometric assessment and engagement with end users for their design can vary significantly. This scoping [...] Read more.

(1) Background: In healthcare settings, patient-reported outcome measures (PROMs) and surveys are accepted, patient-centered measures that provide qualitative information on dimensions of health and wellbeing. The level of psychometric assessment and engagement with end users for their design can vary significantly. This scoping review describes the psychometric and community engagement processes for PROMs and surveys developed for Aboriginal and Torres Strait Islander communities. (2) Methods: The PRISMA ScR guidelines for scoping reviews were followed, aimed at those PROMs and surveys that underwent psychometric assessment. The Aboriginal and Torres Strait Islander Quality Appraisal Tool and a narrative synthesis approach were used. (3) Results: Of 1080 articles, 14 were eligible for review. Most articles focused on a validity assessment of PROMs and surveys, with reliability being less common. Face validity with Aboriginal and Torres Strait Islander communities was reported in most studies, with construct validity through exploratory factor analyses. Methodological design risks were identified in the majority of studies, notably the absence of explicit Indigenous knowledges. Variability existed in the development of PROMs and surveys for Aboriginal and Torres Strait Islander communities. (4) Conclusions: Improvement in inclusion of Indigenous knowledges and research approaches is needed to ensure relevance and appropriate PROM structures. We provide suggestions for research teams to assist in future design. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

Other

Jump to: Research, Review

16 pages, 961 KiB

Open AccessStudy Protocol

Partnering with Aboriginal and Torres Strait Islander Peoples: An Evaluation Study Protocol to Strengthen a Comprehensive Multi-Scale Evaluation Framework for Participatory Systems Modelling through Indigenous Paradigms and Methodologies

by Grace Yeeun Lee, Julie Robotham, Yun Ju C. Song, Jo-An Occhipinti, Jakelin Troy, Tanja Hirvonen, Dakota Feirer, Olivia Iannelli, Victoria Loblay, Louise Freebairn, Rama Agung-Igusti, Ee Pin Chang, Pat Dudgeon and Ian Bernard Hickie

Int. J. Environ. Res. Public Health 2023, 20(1), 53; https://doi.org/10.3390/ijerph20010053 - 21 Dec 2022

Cited by 1 | Viewed by 3204

Abstract

The social and emotional wellbeing of young Aboriginal and Torres Strait Islander peoples should be supported through an Indigenous-led and community empowering approach. Applying systems thinking via participatory approaches is aligned with Aboriginal and Torres Strait Islander research paradigms and can be an [...] Read more.

The social and emotional wellbeing of young Aboriginal and Torres Strait Islander peoples should be supported through an Indigenous-led and community empowering approach. Applying systems thinking via participatory approaches is aligned with Aboriginal and Torres Strait Islander research paradigms and can be an effective method to deliver a decision support tool for mental health systems planning for Indigenous communities. Evaluations are necessary to understand the effectiveness and value of such methods, uncover protective and healing factors of social and emotional wellbeing, as well as to promote Aboriginal and Torres Strait Islander self-determination over allocation of funding and resources. This paper presents modifications to a published evaluation protocol for participatory systems modelling to align with critical Aboriginal and Torres Strait Islander guidelines and recommendations to support the social and emotional wellbeing of young people. This paper also presents a culturally relevant participatory systems modelling evaluation framework. Recognizing the reciprocity, strengths, and expertise Aboriginal and Torres Strait Islander methodologies can offer to broader research and evaluation practices, the amended framework presented in this paper facilitates empowering evaluation practices that should be adopted when working with Aboriginal and Torres Strait Islander peoples as well as when working with other diverse, non-Indigenous communities. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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38 pages, 1296 KiB

Open AccessSystematic Review

A Comprehensive Review of Optimal Approaches to Co-Design in Health with First Nations Australians

by Tamara Butler, Alana Gall, Gail Garvey, Khwanruethai Ngampromwongse, Debra Hector, Scott Turnbull, Kerri Lucas, Caroline Nehill, Anna Boltong, Dorothy Keefe and Kate Anderson

Int. J. Environ. Res. Public Health 2022, 19(23), 16166; https://doi.org/10.3390/ijerph192316166 - 02 Dec 2022

Cited by 15 | Viewed by 7325

Abstract

Background: Australia’s social, structural, and political context, together with the continuing impact of colonisation, perpetuates health care and outcome disparities for First Nations Australians. A new approach led by First Nations Australians is required to address these disparities. Co-design is emerging as a [...] Read more.

Background: Australia’s social, structural, and political context, together with the continuing impact of colonisation, perpetuates health care and outcome disparities for First Nations Australians. A new approach led by First Nations Australians is required to address these disparities. Co-design is emerging as a valued method for First Nations Australian communities to drive change in health policy and practice to better meet their needs and priorities. However, it is critical that co-design processes and outcomes are culturally safe and effective. Aims: This project aimed to identify the current evidence around optimal approaches to co-design in health with First Nations Australians. Methods: First Nations Australian co-led team conducted a comprehensive review to identify peer-reviewed and grey literature reporting the application of co-design in health-related areas by and with First Nations Australians. A First Nations Co-Design Working Group (FNCDWG) was established to guide this work and team.A Collaborative Yarning Methodology (CYM) was used to conduct a thematic analysis of the included literature. Results: After full-text screening, 99 studies were included. Thematic analysis elicited the following six key themes, which included 28 practical sub-themes, relevant to co-design in health with First Nations Australians: First Nations Australians leadership; Culturally grounded approach; Respect; Benefit to First Nations communities; Inclusive partnerships; and Evidence-based decision making. Conclusion: The findings of this review provide a valuable snapshot of the existing evidence to be used as a starting point to guide appropriate and effective applications of co-design in health with First Nations Australians. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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7 pages, 308 KiB

Open AccessCommentary

Aboriginal Community Controlled Health Services: An Act of Resistance against Australia’s Neoliberal Ideologies

by Brianna F. Poirier, Joanne Hedges, Gustavo Soares and Lisa M. Jamieson

Int. J. Environ. Res. Public Health 2022, 19(16), 10058; https://doi.org/10.3390/ijerph191610058 - 15 Aug 2022

Cited by 4 | Viewed by 3036

Abstract

The individualistic and colonial foundations of neoliberal socio-political ideologies are embedded throughout Australian health systems, services, and discourses. Not only does neoliberalism undermine Aboriginal and Torres Strait Islander collectivist values by emphasizing personal autonomy, but it has significant implications for Aboriginal and Torres [...] Read more.

The individualistic and colonial foundations of neoliberal socio-political ideologies are embedded throughout Australian health systems, services, and discourses. Not only does neoliberalism undermine Aboriginal and Torres Strait Islander collectivist values by emphasizing personal autonomy, but it has significant implications for Aboriginal and Torres Strait Islander health. Aboriginal Community Controlled Health Services (ACCHS) operate within Community-oriented holistic understandings of well-being that contradict neoliberal values that Western health services operate within. Therefore, this paper aims to explore the role of ACCHS in resisting the pervasive nature of neoliberalism through the prioritization of self-determination for Aboriginal and Torres Strait Islander Peoples. Utilizing a critical evaluative commentary, we reflect on Aboriginal political leadership and advocacy during the 1970s and 1980s and the development of neoliberalism in Australia in the context of ACCHS. Community controlled primary health services across Australia are the only remaining government-funded and Aboriginal-controlled organizations. Not only do ACCHS models resist neoliberal ideologies of reduced public expenditure and dominant individualistic models of care, but they also incontrovertibly strengthen individual and Community health. ACCHS remain the gold standard model by ensuring Aboriginal and Torres Strait Islander rights to the self-determination of health in accordance with the United Nations Declaration of the Rights of Indigenous Peoples. Full article

(This article belongs to the Special Issue Health and Wellness for Indigenous Peoples)

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