International Journal of Environmental Research and Public Health

Editorial

9 pages, 331 KiB

Open AccessEditorial

The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe: Ensuring and Promoting Best Practice in Research

by Kalinda Griffiths, Abbey Diaz, Lisa J. Whop and Joan Cunningham

Int. J. Environ. Res. Public Health 2022, 19(1), 261; https://doi.org/10.3390/ijerph19010261 - 27 Dec 2021

Cited by 13 | Viewed by 5694

Abstract

Indigenous and Tribal peoples account for approximately 6 [...] Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

Research

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17 pages, 334 KiB

Open AccessArticle

by Rubijayne Cohen, Raglan Maddox, Mikala Sedgwick, Katherine A. Thurber, Makayla-May Brinckley, Eden M. Barrett and Raymond Lovett

Int. J. Environ. Res. Public Health 2021, 18(20), 10962; https://doi.org/10.3390/ijerph182010962 - 19 Oct 2021

Cited by 7 | Viewed by 5425

Abstract

Smoking is the leading contributor to the burden of disease and mortality for Aboriginal and Torres Strait Islander peoples, with an estimated 37% of all Aboriginal and Torres Strait Islander deaths attributed to smoking. The Tackling Indigenous Smoking (TIS) program was implemented to [...] Read more.

Smoking is the leading contributor to the burden of disease and mortality for Aboriginal and Torres Strait Islander peoples, with an estimated 37% of all Aboriginal and Torres Strait Islander deaths attributed to smoking. The Tackling Indigenous Smoking (TIS) program was implemented to support people to quit smoking, prevent initiation, and reduce exposure to second-hand smoke. Analysis of baseline (2018–2020) data from a large-scale cohort study was conducted to quantify smoking-related attitudes and behaviours among Aboriginal and Torres Strait Islander adults, overall and in relation to exposure to the TIS program. Most results were similar for TIS and non-TIS, but there was a significantly lower prevalence of smoking inside households (PR0.85; 95% CI: 0.74, 0.97), smoking ≥21 cigarettes per day (PR0.79; 95% CI: 0.62, <1.00), and smoking a first cigarette within 5 min of waking (PR0.87; 95% CI: 0.76, <1.00) in TIS-funded compared to non-TIS-funded areas. Findings from the analysis highlight encouraging anti-smoking attitudes and behaviours across TIS-funded and non-TIS-funded areas, and serve as a basis for future analysis of change in outcomes over time associated with exposure to a large multi-mode population health program (TIS). Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

15 pages, 369 KiB

Open AccessArticle

Human Papillomavirus (HPV) Self-Sampling among Never-and Under-Screened Indigenous Māori, Pacific and Asian Women in Aotearoa New Zealand: A Feasibility Study

by Collette Bromhead, Helen Wihongi, Susan M. Sherman, Sue Crengle, Jane Grant, Georgina Martin, Anna Maxwell, Georgina McPherson, ‘Aivi Puloka, Susan Reid, Nina Scott and Karen Bartholomew

Int. J. Environ. Res. Public Health 2021, 18(19), 10050; https://doi.org/10.3390/ijerph181910050 - 24 Sep 2021

Cited by 12 | Viewed by 4379

Abstract

In Aotearoa, New Zealand, the majority of cervical cancer cases occur in women who have never been screened or are under-screened. Wāhine Māori, Pacific and Asian women have the lowest rate of cervical screening. Self-sampling for human papillomavirus (HPV-SS) has been shown to [...] Read more.

In Aotearoa, New Zealand, the majority of cervical cancer cases occur in women who have never been screened or are under-screened. Wāhine Māori, Pacific and Asian women have the lowest rate of cervical screening. Self-sampling for human papillomavirus (HPV-SS) has been shown to increase participation in cervical cancer screening. A whole-of-system approach, driven by evidence in the most effective delivery of HPV-SS, is required to mitigate further widening of the avoidable gap in cervical screening access and outcomes between groups of women in Aotearoa. This single-arm feasibility and acceptability study of HPV self-sampling invited never- and under-screened (≥5 years overdue) 30–69-year-old women from general practices in Auckland, Aotearoa. Eligible women were identified by data matching between the National Cervical Programme (NCSP) Register and practice data. Focus groups were additionally held with eligible wāhine Māori, Asian and Pacific women to co-design new patient information materials. Questionnaires on HPV knowledge and post-test experience were offered to women. Our follow-up protocols included shared decision-making principles, and we committed to follow-up ≥90% of women who tested positive for HPV. Data matching identified 366 eligible never- and under-screened wāhine Māori, Pacific and Asian women in participating practices. We were only able to contact 114 women, and 17, during the discussion, were found to be ineligible. Identifying and contacting women overdue for a cervical screen was resource-intensive, with a high rate of un-contactability despite multiple attempts. We found the best uptake of self-sampling was at focus groups. Of the total 84 HPV-SS tests, there were five positive results (6%), including one participant with HPV18 who was found to have a cervical Adenocarcinoma at colposcopy. In our feasibility study, self-sampling was acceptable and effective at detecting HPV and preventing cervical cancer in under-screened urban wāhine Māori, Pacific and Asian women in Aotearoa. This is the first report of cervical Adenocarcinoma (Grade 1B) as a result of an HPV-18 positive self-sample in Aotearoa. We co-designed new patient information materials taking a health literacy and ethnicity-specific approach. This work provides policy-relevant information to the NCSP on the resources required to implement an effective HPV self-sampling programme to improve equity in national cervical cancer screening. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

20 pages, 366 KiB

Open AccessArticle

He Tamariki Kokoti Tau: Families of Indigenous Infants Talk about Their Experiences of Preterm Birth and Neonatal Intensive Care

by Anna Adcock, Fiona Cram, Liza Edmonds and Beverley Lawton

Int. J. Environ. Res. Public Health 2021, 18(18), 9835; https://doi.org/10.3390/ijerph18189835 - 18 Sep 2021

Cited by 12 | Viewed by 4271

Abstract

Māori (Indigenous peoples of Aotearoa New Zealand) bear an unequal burden of poor perinatal health outcomes, including preterm birth. An infant arriving preterm disrupts the birth imaginary of whānau (family collectives) and situates them in a foreign health environment that may not be [...] Read more.

Māori (Indigenous peoples of Aotearoa New Zealand) bear an unequal burden of poor perinatal health outcomes, including preterm birth. An infant arriving preterm disrupts the birth imaginary of whānau (family collectives) and situates them in a foreign health environment that may not be culturally safe and nurturing. A cross-sectional interpretative phenomenological analysis of first interviews with 19 whānau participating in a Kaupapa Māori (by, with, for Māori) qualitative longitudinal study of preterm birth identified themes from their experiences and the meanings they attributed to them. Preterm birth was an emotional roller coaster, with the birth imaginary and anticipated roles disrupted as health practitioners took over the care of their infants. Whānau expressed the desire to be close to their infants, holding them, loving them, nurturing them, and emplacing them within whakapapa (genealogy, continual layering of foundations) networks. When health practitioners or hospital policies inhibited this intimacy by isolating, excluding, or discriminating, whānau were frustrated. Being familiar with hospital routines, staff, peers, infant cares, and being wrapped in wider whānau support were key for whānau coping. Whakawhanaungatanga (processes of establishing relationships) create safe spaces for whānau to be themselves. This quietens the ‘storm’ and returns whānau to a sense of calm, through the reclamation of their environment. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

18 pages, 5210 KiB

Open AccessArticle

From Digital Mental Health to Digital Social and Emotional Wellbeing: How Indigenous Community-Based Participatory Research Influenced the Australian Government’s Digital Mental Health Agenda

by James Bennett-Levy, Judy Singer, Darlene Rotumah, Sarah Bernays and David Edwards

Int. J. Environ. Res. Public Health 2021, 18(18), 9757; https://doi.org/10.3390/ijerph18189757 - 16 Sep 2021

Cited by 8 | Viewed by 8074

Abstract

This paper describes the first six years of a government-initiated project to train Indigenous health professionals in digital mental health (d-MH). It illustrates how community-based participatory research (CBPR) methods were used to enable this “top-down” project to be transformed into a ‘ground-up’ community-guided [...] Read more.

This paper describes the first six years of a government-initiated project to train Indigenous health professionals in digital mental health (d-MH). It illustrates how community-based participatory research (CBPR) methods were used to enable this “top-down” project to be transformed into a ‘ground-up’ community-guided process; and how, in turn, the guidance from the local Indigenous community partners went on to influence the national government’s d-MH agenda. The CBPR partnership between five community partners and a university rural health department is described, with illustrations of how CBPR harnessed the community’s voice in making the project relevant to their wellbeing needs. The local Indigenous community’s involvement led to a number of unexpected outcomes, which impacted locally and nationally. At an early stage, the conceptual framework of the project was changed from d-MH to the culturally-relevant Indigenous framework of digital social and emotional wellbeing (d-SEWB). This led to a significant expansion of the range and type of digital resources; and to other notable outcomes such as successful advocacy for an Aboriginal-specific online therapy program and for a dedicated “one-stop-shop” d-SEWB website, Wellmob, which was funded by the Australian government in 2019–2021. Some of the implications of this project for future Indigenous CBPR projects are discussed. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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12 pages, 323 KiB

Open AccessArticle

Development and Implementation of an HPV Vaccination Survey for American Indians in Cherokee Nation

by Sameer Vali Gopalani, Amanda E. Janitz, Margie Burkhart, Janis E. Campbell, Sydney A. Martinez, Ashley H. White, Sixia Chen, Amber S. Anderson, Stephanie F. Pharr, Scott Patrick and Ashley Comiford

Int. J. Environ. Res. Public Health 2021, 18(17), 9239; https://doi.org/10.3390/ijerph18179239 - 1 Sep 2021

Cited by 2 | Viewed by 2667

Abstract

Improving human papillomavirus (HPV) vaccination rates is a public health priority and a crucial cancer prevention goal. We designed a survey to estimate HPV vaccination coverage and understand factors associated with HPV vaccination among American Indian adolescents aged 9 to 17 years in [...] Read more.

Improving human papillomavirus (HPV) vaccination rates is a public health priority and a crucial cancer prevention goal. We designed a survey to estimate HPV vaccination coverage and understand factors associated with HPV vaccination among American Indian adolescents aged 9 to 17 years in Cherokee Nation, United States. The final survey contains 37 questions across 10 content areas, including HPV vaccination awareness, initiation, reasons, recommendations, and beliefs. This process paper provides an overview of the survey development. We focus on the collaborative process of a tribal–academic partnership and discuss methodological decisions regarding survey sampling, measures, testing, and administration. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

14 pages, 313 KiB

Open AccessArticle

The Adaptation of a Youth Diabetes Prevention Program for Aboriginal Children in Central Australia: Community Perspectives

by Athira Rohit, Leisa McCarthy, Shiree Mack, Bronwyn Silver, Sabella Turner, Louise A. Baur, Karla Canuto, John Boffa, Dana Dabelea, Katherine A. Sauder, Louise Maple-Brown and Renae Kirkham

Int. J. Environ. Res. Public Health 2021, 18(17), 9173; https://doi.org/10.3390/ijerph18179173 - 31 Aug 2021

Cited by 4 | Viewed by 4862

Abstract

This study reports on integrating community perspectives to adapt a family-focused, culturally appropriate behavioural intervention program to prevent diabetes among Aboriginal children (6–11 years) in Central Australia. A participatory action research approach was used to engage a range of service providers, cultural advisors, [...] Read more.

This study reports on integrating community perspectives to adapt a family-focused, culturally appropriate behavioural intervention program to prevent diabetes among Aboriginal children (6–11 years) in Central Australia. A participatory action research approach was used to engage a range of service providers, cultural advisors, and family groups. Appropriateness, acceptability, content, and delivery of a prevention program within the Central Australian context were discussed through a series of workshops with twenty-five service providers and seven family groups separately. The data obtained were deductively coded for thematic analysis. Main findings included: (i) the strong need for a diabetes prevention program that is community owned, (ii) a flexible and culturally appropriate program delivered by upskilling community members as program facilitators, and (iii) consideration of social and environmental factors when implementing the program. It is recommended that a trial of the adapted prevention program for effectiveness and implementation is led by an Aboriginal community-controlled health service. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

13 pages, 560 KiB

Open AccessArticle

Equity in Access: A Mixed Methods Exploration of the National Disability Insurance Scheme Access Program for the Kimberley Region, Western Australia

by Caitlyn S. White, Erica Spry, Emma Griffiths and Emma Carlin

Int. J. Environ. Res. Public Health 2021, 18(17), 8907; https://doi.org/10.3390/ijerph18178907 - 24 Aug 2021

Cited by 6 | Viewed by 4214

Abstract

This study explored the process and early outcomes of work undertaken by a program to increase Aboriginal people’s awareness of, and access to, the National Disability Insurance Scheme (NDIS). This ‘Access Program’ was implemented through the Aboriginal Community Controlled Sector in the remote [...] Read more.

This study explored the process and early outcomes of work undertaken by a program to increase Aboriginal people’s awareness of, and access to, the National Disability Insurance Scheme (NDIS). This ‘Access Program’ was implemented through the Aboriginal Community Controlled Sector in the remote Kimberley region of Western Australia. Access Program staff were interviewed to explore the strengths, challenges, and future directions of the program. The demographics, primary disability types, and NDIS access outcomes for clients who engaged with the program in the first 12 months of its implementation have been described. The Access Program engaged with 373 clients during the study period and assisted 118 of these to achieve access to the NDIS. The program was reported as successful by staff in its aim of connecting eligible people with the NDIS. Vital to this success was program implementation by the Aboriginal Community Controlled Sector. Staff in these organisations held community trust, provided culturally appropriate services, and utilised strengths-based approaches to overcome barriers that have historically hindered Aboriginal people’s engagement with disability services. Our results demonstrate the Access Program is a successful start in increasing awareness of, and access to, the NDIS for Aboriginal people in the Kimberley region. Much work remains to assist the large number of Aboriginal people in the Kimberley region believed to be eligible for NDIS support who are yet to achieve access. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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10 pages, 302 KiB

Open AccessArticle

Black to the Future: Making the Case for Indigenist Health Humanities

by Chelsea Watego, Lisa J. Whop, David Singh, Bryan Mukandi, Alissa Macoun, George Newhouse, Ali Drummond, Amy McQuire, Janet Stajic, Helena Kajlich and Mark Brough

Int. J. Environ. Res. Public Health 2021, 18(16), 8704; https://doi.org/10.3390/ijerph18168704 - 18 Aug 2021

Cited by 26 | Viewed by 7449

Abstract

This paper outlines the development of Indigenist Health Humanities as a new and innovative field of research building an intellectual collective capable of bridging the knowledge gap that hinders current efforts to close the gap in Indigenous health inequality. Bringing together health and [...] Read more.

This paper outlines the development of Indigenist Health Humanities as a new and innovative field of research building an intellectual collective capable of bridging the knowledge gap that hinders current efforts to close the gap in Indigenous health inequality. Bringing together health and the humanities through the particularity of Indigenous scholarship, a deeper understanding of the human experience of health will be developed alongside a greater understanding of the enablers to building a transdisciplinary collective of Indigenist researchers. The potential benefits include a more sustainable, relational, and ethical approach to advancing new knowledge, and health outcomes, for Indigenous people in its fullest sense. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

22 pages, 381 KiB

Open AccessArticle

Collaborative Social-Epidemiology: A Co-analysis of the Cultural and Structural Determinants of Health for Aboriginal Youth in Victorian Schools

by Joanne Nicole Luke, Alister Thorpe, Carlina Black, Lisa Thorpe, David Thomas, Sandra Eades and Kevin Rowley

Int. J. Environ. Res. Public Health 2021, 18(16), 8674; https://doi.org/10.3390/ijerph18168674 - 17 Aug 2021

Cited by 6 | Viewed by 3715

Abstract

Social-epidemiology that excludes Aboriginal voices often fails to capture the full and complex social worlds of Aboriginal people. Using data from an existing co-designed Victorian government Adolescent Health and Wellbeing Survey (2008/9), we worked with Aboriginal organizations to identify data priorities, select measures, [...] Read more.

Social-epidemiology that excludes Aboriginal voices often fails to capture the full and complex social worlds of Aboriginal people. Using data from an existing co-designed Victorian government Adolescent Health and Wellbeing Survey (2008/9), we worked with Aboriginal organizations to identify data priorities, select measures, interpret data, and contextualize findings. Using this participatory co-analysis approach, we selected “cultural” and “structural” determinants identified by Aboriginal organizations as important and modelled these using principal component analysis. Resulting components were then modelled using logistic regression to investigate associations with “likely being well” (Kessler-10 score < 20) for 88 Aboriginal adolescents aged 11–17 years. Principal component analysis grouped 11 structural variables into four components and 11 cultural variables into three components. Of these, “grew up in Aboriginal family/community and connected” associated with significantly higher odds of “likely being well” (OR = 2.26 (1.01–5.06), p = 0.046). Conversely, “institutionally imposed family displacement” had significantly lower odds (OR = 0.49 (0.24–0.97), p = 0.040) and “negative police contact and poverty” non-significantly lower odds (OR = 0.53 (0.26–1.06), p = 0.073) for “likely being well”. Using a co-analysis participatory approach, the voices of Aboriginal researchers and Aboriginal organizations were able to construct a social world that aligned with their ways of knowing, doing, and being. Findings highlighted institutionally imposed family displacement, policing, and poverty as social sites for health intervention and emphasized the importance of strong Aboriginal families for adolescents. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

14 pages, 907 KiB

Open AccessArticle

Co-Designing Health Service Evaluation Tools That Foreground First Nation Worldviews for Better Mental Health and Wellbeing Outcomes

by Michael Wright, Aunty Doris Getta, Aunty Oriel Green, Uncle Charles Kickett, Aunty Helen Kickett, Aunty Irene McNamara, Uncle Albert McNamara, Aunty Moya Newman, Aunty Charmaine Pell, Aunty Millie Penny, Uncle Peter Wilkes, Aunty Sandra Wilkes, Tiana Culbong, Kathrine Taylor, Alex Brown, Pat Dudgeon, Glenn Pearson, Steve Allsop, Ashleigh Lin, Geoff Smith, Brad Farrant, Leanne Mirabella and Margaret O’Connell Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2021, 18(16), 8555; https://doi.org/10.3390/ijerph18168555 - 13 Aug 2021

Cited by 16 | Viewed by 6272

Abstract

It is critical that health service evaluation frameworks include Aboriginal people and their cultural worldviews from design to implementation. During a large participatory action research study, Elders, service leaders and Aboriginal and non-Aboriginal researchers co-designed evaluation tools to test the efficacy of a [...] Read more.

It is critical that health service evaluation frameworks include Aboriginal people and their cultural worldviews from design to implementation. During a large participatory action research study, Elders, service leaders and Aboriginal and non-Aboriginal researchers co-designed evaluation tools to test the efficacy of a previously co-designed engagement framework. Through a series of co-design workshops, tools were built using innovative collaborative processes that foregrounded Aboriginal worldviews. The workshops resulted in the development of a three-way survey that records the service experiences related to cultural safety from the perspective of Aboriginal clients, their carer/s, and the service staff with whom they work. The surveys centralise the role of relationships in client-service interactions, which strongly reflect their design from an Aboriginal worldview. This paper provides new insights into the reciprocal benefits of engaging community Elders and service leaders to work together to develop new and more meaningful ways of servicing Aboriginal families. Foregrounding relationships in service evaluations reinstates the value of human connection and people-centred engagement in service delivery which are central to rebuilding historically fractured relationships between mainstream services and Aboriginal communities. This benefits not only Aboriginal communities, but also other marginalised populations expanding the remit of mainstream services to be accessed by many. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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16 pages, 341 KiB

Open AccessArticle

A Qualitative Study Exploring the Experiences and Perspectives of Australian Aboriginal Women on Oral Health during Pregnancy

by Ariana Kong, Michelle Dickson, Lucie Ramjan, Mariana S. Sousa, Joanne Goulding, Jemma Chao and Ajesh George

Int. J. Environ. Res. Public Health 2021, 18(15), 8061; https://doi.org/10.3390/ijerph18158061 - 29 Jul 2021

Cited by 9 | Viewed by 3970

Abstract

The aim of this study was to explore whether oral health was an important consideration for Aboriginal and Torres Strait Islander women during pregnancy, whether oral health could be promoted by Aboriginal health staff, and strategies that would be appropriate to use in [...] Read more.

The aim of this study was to explore whether oral health was an important consideration for Aboriginal and Torres Strait Islander women during pregnancy, whether oral health could be promoted by Aboriginal health staff, and strategies that would be appropriate to use in a new model of care. A qualitative descriptive methodology underpinned the study. All participants in this study identified as Aboriginal, with no Torres Strait Islander participants, and were from New South Wales, Australia. The interviews were analysed using inductive thematic analysis. From the data, two themes were constructed. The first theme identified that oral health was not always the first priority for participants as poor accessibility alongside other competing commitments were challenges to accessing oral health services. The second theme highlighted how relationships with personal networks and healthcare providers were essential and could be used to support maternal oral health during pregnancy. Effective strategies to promote oral health during pregnancy for Aboriginal and Torres Strait Islander women should involve key stakeholders and health care providers, like Aboriginal Health Workers, to facilitate culturally safe support and tailored oral health advice. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

18 pages, 604 KiB

Open AccessArticle

Culturally Adaptive Governance—Building a New Framework for Equity in Aboriginal and Torres Strait Islander Health Research: Theoretical Basis, Ethics, Attributes and Evaluation

by Daniel L.M. Duke, Megan Prictor, Elif Ekinci, Mariam Hachem and Luke J. Burchill

Int. J. Environ. Res. Public Health 2021, 18(15), 7943; https://doi.org/10.3390/ijerph18157943 - 27 Jul 2021

Cited by 15 | Viewed by 6660

Abstract

Indigenous health inequities persist in Australia due to a system of privilege and racism that has political, economic and social determinants, rather than simply genetic or behavioural causes. Research involving Aboriginal and Torres Strait Islander (‘Indigenous’) communities is routinely funded to understand and [...] Read more.

Indigenous health inequities persist in Australia due to a system of privilege and racism that has political, economic and social determinants, rather than simply genetic or behavioural causes. Research involving Aboriginal and Torres Strait Islander (‘Indigenous’) communities is routinely funded to understand and address these health inequities, yet current ethical and institutional conventions for Indigenous health research often fall short of community expectations. Typically, mainstream research projects are undertaken using traditional “top-down” approaches to governance that hold inherent tensions with other dominant governance styles and forms. This approach perpetuates long-held power imbalances between those leading the research and those being researched. As an alternative, Indigenous governance focuses on the importance of place, people, relationships and process for addressing power imbalances and achieving equitable outcomes. However, empowering principles of Indigenous governance in mainstream environments is a major challenge for research projects and teams working within organisations that are regulated by Western standards and conventions. This paper outlines the theoretical basis for a new Culturally Adaptive Governance Framework (CAGF) for empowering principles of Indigenous governance as a prerequisite for ethical conduct and practice in Indigenous health research. We suggest new orientations for mainstream research project governance, predicated on translating theoretical and practical attributes of real-world ethics, adaptive governance and critical allyship frameworks to Indigenous health research. The CAGF is being implemented in a national Indigenous multicenter trial evaluating the use of continuous blood glucose monitors as a new technology with the potential to improve diabetes care and treatment for Indigenous Australians—the FlashGM Study. The CAGF is a governance framework that identifies the realities of power, acknowledges the complexities of culture and emerging health technologies, and foregrounds the principle of equity for mainstream Indigenous health research. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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12 pages, 2010 KiB

Open AccessArticle

The Fabric of Aboriginal and Torres Strait Islander Wellbeing: A Conceptual Model

by Gail Garvey, Kate Anderson, Alana Gall, Tamara L. Butler, Lisa J. Whop, Brian Arley, Joan Cunningham, Michelle Dickson, Alan Cass, Julie Ratcliffe, Allison Tong and Kirsten Howard

Int. J. Environ. Res. Public Health 2021, 18(15), 7745; https://doi.org/10.3390/ijerph18157745 - 21 Jul 2021

Cited by 39 | Viewed by 10703

Abstract

Wellbeing is culturally bound and is shaped by many aspects of life, including experiences, beliefs and values. As such, in order to accurately measure wellbeing for a specific cultural group, it is necessary to understand the experiences, beliefs and values that influence the [...] Read more.

Wellbeing is culturally bound and is shaped by many aspects of life, including experiences, beliefs and values. As such, in order to accurately measure wellbeing for a specific cultural group, it is necessary to understand the experiences, beliefs and values that influence the conception and experience of wellbeing of that group. This paper presents a conceptual model of wellbeing for Aboriginal and Torres Strait Islander people, which was developed from a large national qualitative study that explored the views of 359 Aboriginal and Torres Strait Islander adults. An Aboriginal- and Torres Strait Islander-led research team used an Indigenist research approach to iteratively develop this conceptual model, called the Fabric of Aboriginal and Torres Strait Islander Wellbeing model, which takes inspiration from Aboriginal and Torres Strait Islander weaving traditions whereby individual strands are twined to create fabrics that are both beautiful and strong. This reflects our findings that the parts of life that are most important to wellbeing for many Aboriginal and Torres Strait Islander people are interwoven with their families, communities and culture. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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16 pages, 358 KiB

Open AccessArticle

“We Have to Be Strong Ourselves”: Exploring the Support Needs of Informal Carers of Aboriginal and Torres Strait Islander People with Cancer

by Lorraine Bell, Kate Anderson, Afaf Girgis, Samar Aoun, Joan Cunningham, Claire E. Wakefield, Shaouli Shahid, Allan Ben Smith, Abbey Diaz, Daniel Lindsay, Adam Masa and Gail Garvey

Int. J. Environ. Res. Public Health 2021, 18(14), 7281; https://doi.org/10.3390/ijerph18147281 - 7 Jul 2021

Cited by 6 | Viewed by 3366

Abstract

Informal carers provide an important role in supporting people with cancer. Aboriginal and Torres Strait Islander peoples experience higher cancer mortality than other Australians. To date, very little is known about the support needs of carers of Aboriginal and Torres Strait Islander adults [...] Read more.

Informal carers provide an important role in supporting people with cancer. Aboriginal and Torres Strait Islander peoples experience higher cancer mortality than other Australians. To date, very little is known about the support needs of carers of Aboriginal and Torres Strait Islander adults with cancer. This article explored these needs through a qualitative study. Twenty-two semi-structured qualitative interviews and one focus group were conducted with carers of Aboriginal and Torres Strait Islander adults with cancer (n = 12) and Aboriginal and Torres Strait Islander cancer survivors (n = 15) from Queensland, Australia. Half of the carers interviewed were Aboriginal or Torres Strait Islander Australians. Interviews were transcribed, coded and thematically analysed following an interpretive phenomenological approach. Thematic analysis of carer and survivor interviews revealed four key themes relating to carers’ needs: managing multiple responsibilities; maintaining the carer’s own health and wellbeing; accessing practical support and information; and engaging with the health system. Within these overarching themes, multiple needs were identified including specific needs relevant for carers of Aboriginal and Torres Strait Islander peoples, such as advocating for the patient; accessing Indigenous support services and health workers; and ensuring that the cultural needs of the person are recognised and respected. Identifying the needs of informal carers of Aboriginal and Torres Strait Islander cancer patients will enable greater understanding of the support that carers require and inform the development of strategies to meet these areas of need. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

17 pages, 1685 KiB

Open AccessArticle

“You Can’t Work with My People If You Don’t Know How to”: Enhancing Transfer of Care from Hospital to Primary Care for Aboriginal Australians with Chronic Disease

by Ilse Blignault, Liz Norsa, Raylene Blackburn, George Bloomfield, Karen Beetson, Bin Jalaludin and Nathan Jones

Int. J. Environ. Res. Public Health 2021, 18(14), 7233; https://doi.org/10.3390/ijerph18147233 - 6 Jul 2021

Cited by 8 | Viewed by 6086

Abstract

Indigenous Australians experience significantly poorer health compared to other Australians, with chronic disease contributing to two-thirds of the health gap. We report on an evaluation of an innovative model that leverages mainstream and Aboriginal health resources to enable safe, supported transfer of care [...] Read more.

Indigenous Australians experience significantly poorer health compared to other Australians, with chronic disease contributing to two-thirds of the health gap. We report on an evaluation of an innovative model that leverages mainstream and Aboriginal health resources to enable safe, supported transfer of care for Aboriginal adults with chronic conditions leaving hospital. The multisite evaluation was Aboriginal-led and underpinned by the principles of self-determination and equity and Indigenous research protocols. The qualitative study documented processes and captured service user and provider experiences. We found benefits for patients and their families, the hospital and the health system. The new model enhanced the patient journey and trust in the health service and was a source of staff satisfaction. Challenges included staff availability, patient identification and complexity and the broader issue of cultural safety. Critical success factors included strong governance with joint cultural and clinical leadership and enduring relationships and partnerships at the service delivery, organisation and system levels. A holistic model of care, bringing together cultural and clinical expertise and partnering with Indigenous community organisations, can enhance care coordination and safety across the hospital–community interface. It is important to consider context as well as specific program elements in design, implementation and evaluation. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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21 pages, 358 KiB

Open AccessFeature PaperArticle

What Matters 2 Adults (WM2Adults): Understanding the Foundations of Aboriginal and Torres Strait Islander Wellbeing

by Gail Garvey, Kate Anderson, Alana Gall, Tamara L. Butler, Joan Cunningham, Lisa J. Whop, Michelle Dickson, Julie Ratcliffe, Alan Cass, Allison Tong, Brian Arley and Kirsten Howard

Int. J. Environ. Res. Public Health 2021, 18(12), 6193; https://doi.org/10.3390/ijerph18126193 - 8 Jun 2021

Cited by 22 | Viewed by 6946

Abstract

Aboriginal and Torres Strait Islander people experience a greater range of health and social disadvantages compared to other Australians. Wellbeing is a culturally-bound construct, and to date, a national evidence base around the components of wellbeing for Aboriginal and Torres Strait Islander people [...] Read more.

Aboriginal and Torres Strait Islander people experience a greater range of health and social disadvantages compared to other Australians. Wellbeing is a culturally-bound construct, and to date, a national evidence base around the components of wellbeing for Aboriginal and Torres Strait Islander people is lacking. Understanding and measurement of wellbeing for this population is critical in achieving health equity. This paper aims to identify and describe the foundations of wellbeing for Aboriginal and Torres Strait Islander adults. This national qualitative study was underpinned by an Indigenist research approach which privileges the voices of Aboriginal and Torres Strait Islander people. Aboriginal and Torres Strait Islander adults were purposively recruited from around Australia between September 2017 and September 2018 to participate in Yarning Circles, led by Aboriginal and Torres Strait Islander researchers. Yarning Circles were audio recorded, transcribed and analyzed. A Collaborative Yarning Methodology was used, which incorporated reflexive thematic analysis to identify and describe the foundations of wellbeing reported by participants. A total of 359 Aboriginal and Torres Strait Islander adults participated. Our analysis revealed five foundations of wellbeing: belonging and connection; holistic health; purpose and control; dignity and respect; and basic needs. These foundations were deeply interwoven by three interconnected aspects of Aboriginal and Torres Strait Islander life: family, community and culture. The findings of this study will substantially aid our efforts to develop a new wellbeing measure for Aboriginal and Torres Strait Islander adults. The iterative Indigenist methods used in this study provide a robust research methodology for conducting large-scale, nationally-relevant qualitative research with Aboriginal and Torres Strait Islander people. Policies and practices that are informed by our results have the potential to address outcomes that are meaningful for Aboriginal and Torres Strait Islander people. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

13 pages, 310 KiB

Open AccessArticle

“The Land Nurtures Our Spirit”: Understanding the Role of the Land in Labrador Innu Wellbeing

by Leonor Mercedes Ward, Mary Janet Hill, Nikashant Antane, Samia Chreim, Anita Olsen Harper and Samantha Wells

Int. J. Environ. Res. Public Health 2021, 18(10), 5102; https://doi.org/10.3390/ijerph18105102 - 12 May 2021

Cited by 17 | Viewed by 5396

Abstract

We examined Indigenous views of wellbeing, aiming to understand how the Labrador Innu view influence of land on their health. The Innu live in two First Nation communities (Sheshatshiu and Natuashish) in the subarctic portion of the province of Newfoundland and Labrador, Canada. [...] Read more.

We examined Indigenous views of wellbeing, aiming to understand how the Labrador Innu view influence of land on their health. The Innu live in two First Nation communities (Sheshatshiu and Natuashish) in the subarctic portion of the province of Newfoundland and Labrador, Canada. Their views on land and wellbeing are context specific and have not been studied; our research addresses this significant gap in literature. Findings highlight that the experience of being on the land with family and community, learning cultural knowledge, and gaining a sense of identity play a major role in enhancing wellbeing. Externally imposed policies and programs conceiving Indigenous land as a physical place only fail to understand that land sustains wellbeing by emplacing knowledge systems and cultural identity. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

12 pages, 293 KiB

Open AccessArticle

“There Is a Lot of Practice in Not Thinking about That”: Structural, Interpersonal, and Individual-Level Barriers to HIV/STI Prevention among Reservation Based American Indians

by Richard F Armenta, Daniel Kellogg, Jessica L Montoya, Rick Romero, Shandiin Armao, Daniel Calac and Tommi L Gaines

Int. J. Environ. Res. Public Health 2021, 18(7), 3566; https://doi.org/10.3390/ijerph18073566 - 30 Mar 2021

Cited by 9 | Viewed by 3114

Abstract

American Indians (AI) face significant disparities in HIV/STI morbidity and mortality, and historical, structural, interpersonal, and individual level barriers stymie prevention efforts. The objective of this paper is to examine barriers to HIV/STI prevention among reservation-based AI. We conducted face-to-face qualitative interviews with [...] Read more.

American Indians (AI) face significant disparities in HIV/STI morbidity and mortality, and historical, structural, interpersonal, and individual level barriers stymie prevention efforts. The objective of this paper is to examine barriers to HIV/STI prevention among reservation-based AI. We conducted face-to-face qualitative interviews with 17 reservation-based AI community leaders and community members in Southern California on HIV/STI knowledge and attitudes and barriers to prevention. The disruption of traditional coping mechanisms and healing processes were compromised by historical trauma, and this allowed stigmas to exist where they did not exist before. This impacted access to healthcare services and trust in medicine, and is linked to individuals adopting negative coping behaviors that confer risk for HIV/STI transmission (e.g., substance use and sexual behaviors). Most of the participants reported that HIV/STIs were not discussed in their reservation-based communities, and many participants had a misperception of transmission risk. Stigma was also linked to a lack of knowledge and awareness of HIV/STI’s. Limited available services, remoteness of communities, perceived lack of privacy, and low cultural competency among providers further hindered the access and use of HIV/STI prevention services. These findings highlight the need to address the historical, structural, and interpersonal factors impacting individual-level behaviors that can increase HIV/STI transmission among reservation-based AIs. Prevention work should build on community strengths to increase HIV/STI knowledge, reduce stigma, and increase access to preventative care while using culturally grounded methodologies. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

20 pages, 1655 KiB

Open AccessArticle

Examining the Associations between Indigenous Rangers, Culture and Wellbeing in Australia, 2018–2020

by Alyson Wright, Mandy Yap, Roxanne Jones, Alice Richardson, Vanessa Davis and Raymond Lovett

Int. J. Environ. Res. Public Health 2021, 18(6), 3053; https://doi.org/10.3390/ijerph18063053 - 16 Mar 2021

Cited by 17 | Viewed by 5330

Abstract

The centrality of culture to Indigenous peoples’ health and wellbeing is becoming increasingly acknowledged in government policy. In Australia, the Indigenous Ranger program is a leading example of employment that supports increased cultural participation. In 2017, we demonstrated higher life satisfaction and family [...] Read more.

The centrality of culture to Indigenous peoples’ health and wellbeing is becoming increasingly acknowledged in government policy. In Australia, the Indigenous Ranger program is a leading example of employment that supports increased cultural participation. In 2017, we demonstrated higher life satisfaction and family wellbeing among Indigenous Rangers compared to non-Rangers in Central Australia. Using an expanded national dataset, this present study aimed to: examine if associations between Ranger status and wellbeing continued to be observed in Central Australia; assess if these associations were observed among non-Central Australian Rangers; and, quantify the effect of mediating variables (Rangers status, cultural factors) on wellbeing outcomes. We analyzed Mayi Kuwayu baseline data (n = 9691 Aboriginal and Torres Strait Islander people) and compared participants who identified as past or currently employed Rangers compared to non-Rangers across two geographic locations (Central Australia, non-Central Australia). Ranger participation was significantly associated with very high life satisfaction and family wellbeing in Central Australia (high life satisfaction PR 1.31, 95% CI 1.09–1.57, and family wellbeing (PR 1.17, 95% CI 1.01–1.36) and non-Central Australia (high life satisfaction PR 1.29, 95% CI 1.06–1.57), family wellbeing (PR 1.37, 95% CI 1.14–1.65). These findings concord with those observed in the 2017 proof-of-concept study. Additionally, we found that Ranger status partially mediated the relationships between existing cultural practices (first language as your Indigenous language and living on your country) and the two wellbeing outcomes. Current cultural practices, spending time on country and speaking your Aboriginal language, also partially mediated the associations between Ranger status and high life satisfaction, and between Ranger status and high family wellbeing. This analysis supports evidence that both Ranger employment and cultural participation are contributors to wellbeing. Ranger work is not only good for land, but it is good for people. As such, determining policies that mutually acknowledge and enhance culture, health and wellbeing will likely have additional benefits for the broader Aboriginal and Torres Strait Islander population. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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13 pages, 850 KiB

Open AccessArticle

Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia

by Davida Nolan-Isles, Rona Macniven, Kate Hunter, Josephine Gwynn, Michelle Lincoln, Rachael Moir, Yvonne Dimitropoulos, Donna Taylor, Tim Agius, Heather Finlayson, Robyn Martin, Katrina Ward, Susannah Tobin and Kylie Gwynne

Int. J. Environ. Res. Public Health 2021, 18(6), 3014; https://doi.org/10.3390/ijerph18063014 - 15 Mar 2021

Cited by 85 | Viewed by 47048

Abstract

Background: Australia’s healthcare system is complex and fragmented which can create challenges in healthcare, particularly in rural and remote areas. Aboriginal people experience inequalities in healthcare treatment and outcomes. This study aimed to investigate barriers and enablers to accessing healthcare services for Aboriginal [...] Read more.

Background: Australia’s healthcare system is complex and fragmented which can create challenges in healthcare, particularly in rural and remote areas. Aboriginal people experience inequalities in healthcare treatment and outcomes. This study aimed to investigate barriers and enablers to accessing healthcare services for Aboriginal people living in regional and remote Australia. Methods: Semi-structured interviews were conducted with healthcare delivery staff and stakeholders recruited through snowball sampling. Three communities were selected for their high proportion of Aboriginal people and diverse regional and remote locations. Thematic analysis identified barriers and enablers. Results: Thirty-one interviews were conducted in the three communities (n = 5 coastal, n = 13 remote, and n = 13 border) and six themes identified: (1) Improved coordination of healthcare services; (2) Better communication between services and patients; (3) Trust in services and cultural safety; (4) Importance of prioritizing health services by Aboriginal people; (5) Importance of reliable, affordable and sustainable services; (6) Distance and transport availability. These themes were often present as both barriers and enablers to healthcare access for Aboriginal people. They were also present across the healthcare system and within all three communities. Conclusions: This study describes a pathway to better healthcare outcomes for Aboriginal Australians by providing insights into ways to improve access. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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17 pages, 5509 KiB

Open AccessArticle

Local-Indigenous Autonomy and Community Streetscape Enhancement: Learnings from Māori and Te Ara Mua—Future Streets Project

by Kimiora Raerino, Alex Macmillan, Adrian Field and Rau Hoskins

Int. J. Environ. Res. Public Health 2021, 18(3), 865; https://doi.org/10.3390/ijerph18030865 - 20 Jan 2021

Cited by 10 | Viewed by 5614

Abstract

In settler countries, attention is now extending to the wellbeing benefits of recognising and promoting the Indigenous cultural identity of neighbourhoods as a contributing factor to more equitable and healthier communities. Re-indigenisation efforts to (re)implement cultural factors into urban design can be challenging [...] Read more.

In settler countries, attention is now extending to the wellbeing benefits of recognising and promoting the Indigenous cultural identity of neighbourhoods as a contributing factor to more equitable and healthier communities. Re-indigenisation efforts to (re)implement cultural factors into urban design can be challenging and ineffective without the leadership and collaboration of local-Indigenous peoples. Undertaken in Aotearoa New Zealand, Te Ara Mua — Future Street project, demonstrated that co-design has critical potential in the reclamation of Indigenous autonomy, increased local-Indigenous presence and revitalisation of cultural identity. Employing a Kaupapa Māori (Māori-centred) research approach, we focused on the workings and perspectives of mana whenua (local-Indigenous peoples) and community stakeholder engagement in Te Ara Mua. An Indigenous theoretical framework, Te Pae Mahutonga, was utilised in the data analysis to explore perspectives of Indigenous collective agency, empowerment, and wellbeing. Our research demonstrates that developing capacity amongst Indigenous communities is integral for effective engagement and that the realisation of autonomy in urban design projects has broader implications for Indigenous sovereignty, spatial justice and health equity. Significantly, we argue that future community enhancement strategies must include not only re-designing and re-imagining initiatives, but also re-indigenising. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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20 pages, 400 KiB

Open AccessArticle

How Neoliberalism Shapes Indigenous Oral Health Inequalities Globally: Examples from Five Countries

by Lisa Jamieson, Joanne Hedges, Sheri McKinstry, Pauline Koopu and Kamilla Venner

Int. J. Environ. Res. Public Health 2020, 17(23), 8908; https://doi.org/10.3390/ijerph17238908 - 30 Nov 2020

Cited by 19 | Viewed by 5937

Abstract

Evidence suggests that countries with neoliberal political and economic philosophical underpinnings have greater health inequalities compared to less neoliberal countries. But few studies examine how neoliberalism specifically impacts health inequalities involving highly vulnerable populations, such as Indigenous groups. Even fewer take this perspective [...] Read more.

Evidence suggests that countries with neoliberal political and economic philosophical underpinnings have greater health inequalities compared to less neoliberal countries. But few studies examine how neoliberalism specifically impacts health inequalities involving highly vulnerable populations, such as Indigenous groups. Even fewer take this perspective from an oral health viewpoint. From a lens of indigenous groups in five countries (the United States, Canada, Australia, Aotearoa/New Zealand and Norway), this commentary provides critical insights of how neoliberalism, in domains including colonialism, racism, inter-generational trauma and health service provision, shapes oral health inequalities among Indigenous societies at a global level. We posit that all socially marginalised groups are disadvantaged under neoliberalism agendas, but that this is amplified among Indigenous groups because of ongoing legacies of colonialism, institutional racism and intergenerational trauma. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

13 pages, 680 KiB

Open AccessArticle

“Cultural Security Is an On-Going Journey…” Exploring Views from Staff Members on the Quality and Cultural Security of Services for Aboriginal Families in Western Australia

by Lina Gubhaju, Robyn Williams, Jocelyn Jones, David Hamer, Carrington Shepherd, Dan McAullay, Sandra J. Eades and Bridgette McNamara

Int. J. Environ. Res. Public Health 2020, 17(22), 8480; https://doi.org/10.3390/ijerph17228480 - 16 Nov 2020

Cited by 6 | Viewed by 6933

Abstract

Cultural security is a key element of accessible services for Indigenous peoples globally, although few studies have examined this empirically. We explored the scope, reach, quality, and cultural security of health and social services available to Aboriginal and/or Torres Strait Islander families in [...] Read more.

Cultural security is a key element of accessible services for Indigenous peoples globally, although few studies have examined this empirically. We explored the scope, reach, quality, and cultural security of health and social services available to Aboriginal and/or Torres Strait Islander families in Western Australia (WA), from the point of view of staff from the services. We recruited staff from health and social services for Aboriginal people in the Perth, Kalgoorlie, Great Southern, and South West regions of WA between December 2015 and September 2017 to complete online surveys. We examined the proportions of participants that responded saying the service was culturally secure, the reasons for the response, and perceived factors related to a high-quality service. Sixty participants from 21 services responded to the survey. Seventy-three percent stated the service was culturally secure; however, only 36% stated that the staff employed at the service had sufficient knowledge on cultural security. Participants suggested having Aboriginal staff and better cultural awareness training as methods to improve cultural security within the service. Participants highlighted that staffing, funding for resources, and patient financial difficulties in accessing care as key areas for quality improvement. Much greater effort is required in improving knowledge through on-going training of staff in the practice of culturally safe care. Organisations must also be required to meet specific standards in cultural safety. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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21 pages, 1403 KiB

Open AccessArticle

Trauma and Violence Informed Care Through Decolonising Interagency Partnerships: A Complexity Case Study of Waminda’s Model of Systemic Decolonisation

by Patricia Cullen, Tamara Mackean, Faye Worner, Cleone Wellington, Hayley Longbottom, Julieann Coombes, Keziah Bennett-Brook, Kathleen Clapham, Rebecca Ivers, Maree Hackett and Marlene Longbottom

Int. J. Environ. Res. Public Health 2020, 17(20), 7363; https://doi.org/10.3390/ijerph17207363 - 9 Oct 2020

Cited by 10 | Viewed by 8077

Abstract

Through the lens of complexity, we present a nested case study describing a decolonisation approach developed and implemented by Waminda South Coast Women’s Health and Welfare Aboriginal Corporation. Using Indigenous research methods, this case study has unfolded across three phases: (1) Yarning interviews [...] Read more.

Through the lens of complexity, we present a nested case study describing a decolonisation approach developed and implemented by Waminda South Coast Women’s Health and Welfare Aboriginal Corporation. Using Indigenous research methods, this case study has unfolded across three phases: (1) Yarning interviews with the workforce from four partner health services (n = 24); (2) Yarning circle bringing together key informants from yarning interviews to verify and refine emerging themes (n = 14); (3) Semi-structured interviews with a facilitator of Waminda’s Decolonisation Workshop (n = 1) and participants (n = 10). Synthesis of data has been undertaken in stages through collaborative framework and thematic analysis. Three overarching themes and eight sub-themes emerged that centred on enhancing the capabilities of the workforce and strengthening interagency partnerships through a more meaningful connection and shared decolonisation agenda that centres Aboriginal and Torres Strait Islander families and communities. Health and social services are complex systems that function within the context of colonisation. Waminda’s innovative, model of interagency collaboration enhanced workforce capability through shared language and collective learning around colonisation, racism and Whiteness. This process generated individual, organisational and systemic decolonisation to disable power structures through trauma and violence informed approach to practice. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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9 pages, 271 KiB

Open AccessArticle

‘There’s a Wall There—And That Wall Is Higher from Our Side’: Drawing on Qualitative Interviews to Improve Indigenous Australians’ Experiences of Dental Health Services

by Skye Krichauff, Joanne Hedges and Lisa Jamieson

Int. J. Environ. Res. Public Health 2020, 17(18), 6496; https://doi.org/10.3390/ijerph17186496 - 7 Sep 2020

Cited by 17 | Viewed by 4105

Abstract

Indigenous Australians experience high levels of untreated dental disease compared to non-Indigenous Australians. We sought to gain insight into barriers that prevent Indigenous Australians from seeking timely and preventive dental care. A qualitative study design was implemented, using face-to-face interviews conducted December 2019 [...] Read more.

Indigenous Australians experience high levels of untreated dental disease compared to non-Indigenous Australians. We sought to gain insight into barriers that prevent Indigenous Australians from seeking timely and preventive dental care. A qualitative study design was implemented, using face-to-face interviews conducted December 2019 to February 2020. Participants were 20 Indigenous Australians (10 women and 10 men) representing six South Australian Indigenous groups; Ngarrindjeri, Narungga, Kaurna, Ngadjuri, Wiramu, and Adnyamathanha. Age range was middle-aged to elderly. The setting was participants’ homes or workplaces. The main outcome measures were barriers and enablers to accessing timely and appropriate dental care. The findings were broadly grouped into eight domains: (1) fear of dentists; (2) confusion regarding availability of dental services; (3) difficulties making dental appointments; (4) waiting times; (5) attitudes and empathy of dental health service staff; (6) cultural friendliness of dental health service space; (7) availability of public transport and parking costs; and (8) ease of access to dental clinic. The findings indicate that many of the barriers to Indigenous people accessing timely and appropriate dental care may be easily remedied. Cultural competency training enables barriers to timely access and provision of dental care to Indigenous Australians to be addressed. The findings provide important context to better enable health providers and policy makers to put in place appropriate measures to improve Indigenous people’s oral health, and the Indigenous oral health workforce in Australia. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

Review

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22 pages, 617 KiB

Open AccessReview

Indigenous and Tribal Peoples Data Governance in Health Research: A Systematic Review

by Kalinda E. Griffiths, Jessica Blain, Claire M. Vajdic and Louisa Jorm

Int. J. Environ. Res. Public Health 2021, 18(19), 10318; https://doi.org/10.3390/ijerph181910318 - 30 Sep 2021

Cited by 11 | Viewed by 5696

Abstract

There is increasing potential to improve the research and reporting on the health and wellbeing of Indigenous and Tribal peoples through the collection and (re)use of population-level data. As the data economy grows and the value of data increases, the optimization of data [...] Read more.

There is increasing potential to improve the research and reporting on the health and wellbeing of Indigenous and Tribal peoples through the collection and (re)use of population-level data. As the data economy grows and the value of data increases, the optimization of data pertaining to Indigenous peoples requires governance that defines who makes decisions on behalf of whom and how these data can and should be used. An international a priori PROSPERO (#CRD42020170033) systematic review was undertaken to examine the health research literature to (1) identify, describe, and synthesize definitions and principles; (2) identify and describe data governance frameworks; and (3) identify, describe, and synthesize processes, policies and practices used in Indigenous Data Governance (ID-GOV). Sixty-eight articles were included in the review that found five components that require consideration in the governance of health research data pertaining to Indigenous people. This included (1) Indigenous governance; (2) institutional ethics; (3) socio-political dynamics; (4) data management and data stewardship; and (5) overarching influences. This review provides the first systematic international review of ID-GOV that could potentially be used in a range of governance strategies moving forward in health research. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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24 pages, 529 KiB

Open AccessReview

Smoking Cessation Messages for Pregnant Aboriginal and Torres Strait Islander Women: A Rapid Review of Peer-Reviewed Literature and Assessment of Research Translation of Media Content

by Tara Flemington, Gina La Hera-Fuentes, Michelle Bovill, Allison Hart, Jessica Bennett, Nicole M. Ryan and Gillian Sandra Gould

Int. J. Environ. Res. Public Health 2021, 18(17), 9341; https://doi.org/10.3390/ijerph18179341 - 4 Sep 2021

Cited by 2 | Viewed by 4876

Abstract

This review summarized literature about knowledge, attitudes, and beliefs of Aboriginal and Torres Strait Islander women from Australia who smoke during pregnancy, then examined the extent that existing health promotion materials and media messages aligned with evidence on smoking cessation for pregnant Aboriginal [...] Read more.

This review summarized literature about knowledge, attitudes, and beliefs of Aboriginal and Torres Strait Islander women from Australia who smoke during pregnancy, then examined the extent that existing health promotion materials and media messages aligned with evidence on smoking cessation for pregnant Aboriginal and Torres Strait Islander women. Knowledge, attitudes, and beliefs of pregnant Aboriginal women who smoke tobacco were identified in the literature. Health promotion campaigns were retrieved from a grey literature search with keywords and social and professional networks. Key themes from peer-reviewed papers were compared against the content of health promotion campaigns using the Aboriginal Social and Emotional Wellbeing Model, the Behavior Change Wheel and thematic analysis. Eleven empirical studies and 17 campaigns were included. Empirical studies highlighted women sought holistic care that incorporated nicotine replacement therapy, engaged with their family and community and the potential for education about smoking cessation to empower a woman. Health promotion campaigns had a strong focus on ‘engagement with family and community’, ‘knowledge of risks of smoking,’ ‘giving up vs cutting down’ and ‘culture in language and arts’. There were similarities and variances in the key themes in the research evidence and promotion materials. Topics highly aligned included risks from smoking and quitting related issues. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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31 pages, 754 KiB

Open AccessReview

Wellbeing of Indigenous Peoples in Canada, Aotearoa (New Zealand) and the United States: A Systematic Review

by Alana Gall, Kate Anderson, Kirsten Howard, Abbey Diaz, Alexandra King, Esther Willing, Michele Connolly, Daniel Lindsay and Gail Garvey

Int. J. Environ. Res. Public Health 2021, 18(11), 5832; https://doi.org/10.3390/ijerph18115832 - 28 May 2021

Cited by 41 | Viewed by 9600

Abstract

Despite the health improvements afforded to non-Indigenous peoples in Canada, Aotearoa (New Zealand) and the United States, the Indigenous peoples in these countries continue to endure disproportionately high rates of mortality and morbidity. Indigenous peoples’ concepts and understanding of health and wellbeing are [...] Read more.

Despite the health improvements afforded to non-Indigenous peoples in Canada, Aotearoa (New Zealand) and the United States, the Indigenous peoples in these countries continue to endure disproportionately high rates of mortality and morbidity. Indigenous peoples’ concepts and understanding of health and wellbeing are holistic; however, due to their diverse social, political, cultural, environmental and economic contexts within and across countries, wellbeing is not experienced uniformly across all Indigenous populations. We aim to identify aspects of wellbeing important to the Indigenous people in Canada, Aotearoa and the United States. We searched CINAHL, Embase, PsycINFO and PubMed databases for papers that included key Indigenous and wellbeing search terms from database inception to April 2020. Papers that included a focus on Indigenous adults residing in Canada, Aotearoa and the United States, and that included empirical qualitative data that described at least one aspect of wellbeing were eligible. Data were analysed using the stages of thematic development recommended by Thomas and Harden for thematic synthesis of qualitative research. Our search resulted in 2669 papers being screened for eligibility. Following full-text screening, 100 papers were deemed eligible for inclusion (Aotearoa (New Zealand) n = 16, Canada n = 43, United States n = 41). Themes varied across countries; however, identity, connection, balance and self-determination were common aspects of wellbeing. Having this broader understanding of wellbeing across these cultures can inform decisions made about public health actions and resources. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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Other

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10 pages, 488 KiB

Open AccessPerspective

Perspective Developing Successful Collaborative Research Partnerships with AI/AN Communities

by Jonathan Credo and Jani C. Ingram

Int. J. Environ. Res. Public Health 2021, 18(17), 9089; https://doi.org/10.3390/ijerph18179089 - 28 Aug 2021

Cited by 5 | Viewed by 2687

Abstract

In the United States, American Indian and Alaska Native (AI/AN) people are frequently under- or misrepresented in research and health statistics. A principal reason for this disparity is the lack of collaborative partnerships between researchers and tribes. There are hesitations from both academic [...] Read more.

In the United States, American Indian and Alaska Native (AI/AN) people are frequently under- or misrepresented in research and health statistics. A principal reason for this disparity is the lack of collaborative partnerships between researchers and tribes. There are hesitations from both academic Western scientists and tribal communities to establish new partnerships due to differences in cultural and scientific understanding, from data ownership and privacy to dissemination and project expansion. An infamous example is the mishandling of samples collected from the Havasupai Tribe by Arizona State University (ASU) scientists, leading to a legal battle between the tribe and ASU and ending in a moratorium of research with the Havasupai people. This paper will explore three successful and positive collaborations with a large and small tribe, including how the partnerships were established and the outcomes of the collaboration. In addition, the paper will provide perspective of what needs to be addressed by Western scientists if productive collaborations with tribal groups are to be established. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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8 pages, 270 KiB

Open AccessPerspective

Approaches for Disseminating Environmental Research Findings to Navajo Communities

by Tommy Rock, Lindsey Jones and Jani C. Ingram

Int. J. Environ. Res. Public Health 2021, 18(13), 6753; https://doi.org/10.3390/ijerph18136753 - 23 Jun 2021

Cited by 2 | Viewed by 2363

Abstract

We report the use of three different dissemination approaches for providing environmental research results back to Navajo communities from different research projects. The objectives of the dissemination are to provide the results to the community, have a dialogue about the results, and learn [...] Read more.

We report the use of three different dissemination approaches for providing environmental research results back to Navajo communities from different research projects. The objectives of the dissemination are to provide the results to the community, have a dialogue about the results, and learn more about the environmental concerns of the community for potential future research projects. The first approach utilizes radio announcements and flyers provided to the community announcing dissemination meetings specific to the research projects. The second approach is more collaborative, working with a grassroots organization to organize report-back meetings, as well as one-on-one discussions of the research project. The third approach involves the development of a booklet for distribution to communities along with an oral presentation at the regularly scheduled monthly community meetings to discuss the information. Overall, the second and third approaches are more effective than the first approach in terms of dissemination to a larger number of community members, as well as increased dialogue between the researchers and the communities. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

11 pages, 616 KiB

Open AccessStudy Protocol

Building an Indigenous-Led Evidence Base for Smoking Cessation Care among Aboriginal and Torres Strait Islander Women during Pregnancy and Beyond: Research Protocol for the Which Way? Project

by Michelle Bovill, Catherine Chamberlain, Jessica Bennett, Hayley Longbottom, Shanell Bacon, Belinda Field, Paul Hussein, Robert Berwick, Gillian Gould and Peter O’Mara

Int. J. Environ. Res. Public Health 2021, 18(3), 1342; https://doi.org/10.3390/ijerph18031342 - 2 Feb 2021

Cited by 13 | Viewed by 7588

Abstract

Strong and healthy futures for Aboriginal and Torres Strait Islander people requires engagement in meaningful decision making which is supported by evidence-based approaches. While a significant number of research publications state the research is co-designed, few describe the research process in relation to [...] Read more.

Strong and healthy futures for Aboriginal and Torres Strait Islander people requires engagement in meaningful decision making which is supported by evidence-based approaches. While a significant number of research publications state the research is co-designed, few describe the research process in relation to Indigenous ethical values. Improving the health and wellbeing of Aboriginal and Torres Strait Islander mothers and babies is crucial to the continuation of the oldest living culture in the world. Developing meaningful supports to empower Aboriginal and Torres Strait Islander mothers to quit smoking during pregnancy is paramount to addressing a range of health and wellbeing outcomes. Aboriginal and Torres Strait Islander women have called for non-pharmacological approaches to smoking cessation during pregnancy. We describe a culturally responsive research protocol that has been co-designed and is co-owned with urban and regional Aboriginal communities in New South Wales. The project has been developed in line with the AH&MRC’s (Aboriginal Health & Medical Research Council) updated guidelines for ethical research with Aboriginal and Torres Strait Islander communities. Ethics approvals have been granted by AH&MRC #14541662 University of Newcastle HREC H-2020-0092 and the Local Health District ethics committee 2020/ETH02095. Results will be disseminated through peer reviewed articles, community reports, infographics, and online social media content. Full article

(This article belongs to the Special Issue The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe)

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