scholarly journals The research road less travelled

2009 ◽  
Vol 30 (5) ◽  
pp. 169
Author(s):  
Mick Gooda

If there is one thing that should be clear by now to anyone working in the area of Aboriginal and Torres Strait Islander health, it is that biomedical research carried out in isolation from the Aboriginal and Torres Strait Islander community will not significantly improve health outcomes for Australia?s Indigenous peoples.

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
James M. Gerrard ◽  
Shirley Godwin ◽  
Vivienne Chuter ◽  
Shannon E. Munteanu ◽  
Matthew West ◽  
...  

Abstract Background Developing since colonisation, Australia’s healthcare system has dismissed an ongoing and successful First Nations health paradigm in place for 60,000 years. From Captain James Cook documenting ‘very old’ First Nations Peoples being ‘far more happier than we Europeans’ and Governor Arthur Phillip naming Manly in admiration of the physical health of Gadigal men of the Eora Nation, to anthropologist Daisy Bates’ observation of First Nations Peoples living ‘into their eighties’ and having a higher life expectancy than Europeans; our healthcare system’s shameful cultural safety deficit has allowed for an Aboriginal and Torres Strait Islander child born in Australia today to expect to live 9 years less than a non-Indigenous child. Disproportionately negative healthcare outcomes including early onset diabetes-related foot disease and high rates of lower limb amputation in Aboriginal and Torres Strait Islander Peoples contribute to this gross inequity. Main body In 2020, the Australian Health Practitioner Regulation Authority released the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020–2025 - empowering all registered health practitioners within Australia to provide health care to Aboriginal and Torres Strait Islander Peoples that is inclusive, respectful and safe, as judged by the recipient of care. This recently released strategy is critically important to the podiatry profession in Australia. As clinicians, researchers and educators we have a collective responsibility to engage with this strategy of cultural safety. This commentary defines cultural safety for podiatry and outlines the components of the strategy in the context of our profession. Discussion considers the impact of the strategy on podiatry. It identifies mechanisms for podiatrists in all settings to facilitate safer practice, thereby advancing healthcare to produce more equitable outcomes. Conclusion Aboriginal and Torres Strait Islander Peoples access health services more frequently and have better health outcomes where provision of care is culturally safe. By engaging with the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy, all registered podiatrists in Australia can contribute to achieving equity in health outcomes for Aboriginal and Torres Strait Islander Peoples.


2020 ◽  
Author(s):  
Anna Gotis-Graham ◽  
Rona Macniven ◽  
Kelvin Kong ◽  
Kylie Gwynne

AbstractBackgroundAboriginal and Torres Strait Islander children experience a higher prevalence of ear, nose, and throat (ENT) diseases than non-Indigenous children. Many programs exist that aim to prevent and treat these diseases. Culturally appropriate and timely specialist outreach services may help improve access, service use, and outcomes but there has been a lack of rigorous evaluation of ENT outreach programs to date.ObjectiveTo examine the ability of ENT outreach programs to improve health outcomes among Aboriginal and Torres Strait Islander peopleMethodsWe performed a systematic literature search of nine databases (Medline, CINAHLS, PsychINFO, Embase, Cochrane, Scopus, Global health, Informit Rural health database and Indigenous collection) and grey literature sources for primary studies evaluating ENT outreach services for Aboriginal and Torres Strait Islander Australians. Two authors independently evaluated the eligible articles and extracted relevant information.ResultsOf the 506 studies identified, 15 were included in this review. These 15 studies evaluated eight different programs/activities. Studies were heterogeneous in design so a meta-analysis could not be conducted. Seven studies measured health-related outcomes in middle ear or hearing status; six reported overall positive changes one reported no clinically significant improvements. Five programs/activities and their corresponding studies involved Aboriginal and Torres Strait Islander people and organisations in delivery and evaluation, but involvement in program or study design was unclear.ConclusionWhile some studies demonstrated improved outcomes, the overall ability of ENT programs/activities to improve health outcomes for Aboriginal and Torres Strait Islander children is unclear. The impact of ENT outreach may be limited by a lack of evidence quality, a lack of coordination of services, and the provision of potentially unsustainable services. Improvements in the quality of evidence, service coordination and sustainability would likely improve health outcomes.Strengths and limitations of this studyStudies were identification based on a clearly defined and extensive search strategy based on a priori inclusion and exclusion criteriaStudy appraisal was performed using a relevant tool for mixed methods studiesThe involvement of Aboriginal and Torres Strait Islander people in all aspects of programs and their evaluation was examinedPROSPERO registration numberCRD42019134757


2020 ◽  
Vol 49 (2) ◽  
pp. 119-126
Author(s):  
Janet Stajic

AbstractThe Aboriginal and Torres Strait Islander Health Worker/Practitioner (A&TSIHW) workforce provides not only clinical skills but also responds to specific social and cultural needs of the communities they serve bringing knowledge derived from lived and embodied knowledges. The A&TSIHW is a recognised health professional within the Australian health system; however, this workforce continues to be under-supported, under-recognised and under-utilised. A common discourse in literature written about A&TSIHWs focused on the need to empower and enhance the A&TSIHW capabilities, or rendered the A&TSIHW as part of the problem in improving the health of Indigenous peoples. In contrast, articles written by A&TSIHWs, published in the Aboriginal and Islander Health Worker Journal, tell a different story, one about the limitations of the health system in its ability to care for Indigenous peoples, recognising A&TSIHW leadership. This paper deals with two interrelated tensions—the undervaluing of the A&TSIHW as a clinician and the undervaluing of the A&TSIHW as an academic—both of which the author has had to navigate. It explores the specific challenges of the A&TSIHW academic who too seeks recognition beyond that of ‘assistant’ within the research enterprise, drawing upon personal experiences and engagement with educational institutions, including higher education.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038273
Author(s):  
Anna Gotis-Graham ◽  
Rona Macniven ◽  
Kelvin Kong ◽  
Kylie Gwynne

ObjectiveTo examine the ability of ear, nose and throat (ENT) outreach programmes to improve health outcomes among Aboriginal and Torres Strait Islander people.MethodsWe conducted a systematic literature search of nine databases (Medline, CINAHLS, PsycINFO, Embase, Cochrane, Scopus, Global health, Informit Rural health database and Indigenous collection) and grey literature sources for primary studies evaluating ENT outreach services for Aboriginal and Torres Strait Islander people. This review included English language studies of all types, published between 2000 and 2018, that supplied ENT outreach services to Aboriginal and Torres Strait Islander Australians and provided data to evaluate their aims. Two authors independently evaluated the eligible articles and extracted relevant information. Risk of bias was assessed using the Mixed Methods Assessment Tool.ResultsOf the 506 studies identified, 15 were included in this review. These 15 studies evaluated eight different programs/activities. Studies were heterogeneous in design so a meta-analysis could not be conducted. Seven studies measured health-related outcomes in middle ear or hearing status; six reported overall positive changes one reported no clinically significant improvements. Five programmes/activities and their corresponding studies involved Aboriginal and Torres Strait Islander people and organisations in delivery and evaluation, but involvement in programme or study design was unclear.ConclusionWhile some studies demonstrated improved outcomes, the overall ability of ENT programmes to improve health outcomes for Aboriginal and Torres Strait Islander children is unclear. The impact of ENT outreach may be limited by a lack of quality evidence, service coordination and sustainability. Community codesign and supporting and resourcing local capacity must be a component of outreach programmes and ongoing evaluation is also recommended. Improvements in these areas would likely improve health outcomes.PROSPERO registration numberCRD42019134757.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Simone Nash ◽  
Amit Arora

Abstract Background Aboriginal and Torres Strait Islander peoples continue to experience poorer health outcomes than other population groups. While data specific to Indigenous Australians are scarce, a known social health literacy gradient exists linking low health literacy and poor health outcomes within many minority populations. Improving health literacy among Indigenous Australians is an important way to support self-determination and autonomy in both individuals and communities, by enhancing knowledge and improving health outcomes. This review aims to rigorously examine the effectiveness of health literacy interventions targeting Aboriginal and Torres Strait Islander peoples. Methods A systematic review across six databases (The Cochrane Library, PubMed, Embase, SCOPUS, ProQuest Dissertation and Thesis and Web of Science) was performed for publications evaluating interventions to improve health literacy among Indigenous Australian adults using search terms identifying a range of related outcomes. Results Of 824 articles retrieved, a total of five studies met the eligibility criteria and were included in this review. The included studies evaluated the implementation of workshops, structured exercise classes and the provision of discounted fruit and vegetables to improve nutrition, modify risk factors for chronic diseases, and improve oral health literacy. All interventions reported statistically significant improvement in at least one measured outcome. However, there was limited involvement of the Aboriginal and Torres Strait Islander community members in the research process and participant retention rates were sub-optimal. Conclusion There is limited evidence on interventions to improve health literacy in Indigenous Australian adults. Participation in interventions was often suboptimal and loss to follow-up was high. Future studies co-designed with Aboriginal and Torres Strait Islander community members are needed to improve health literacy in this population.


1998 ◽  
Vol 26 (1) ◽  
pp. 18-24

This article addresses Aboriginal and Torres Strait Islander health problems and critically investigates current government policies which are attempting to raise the health standards of these Indigenous people. Particular emphasis will be placed on the Queensland Aboriginal and Torres Strait Islander population, which, according to the Australian Bureau of Statistics census in 1986, stood at just over 61,000 or 2.4 per cent of the State's population.


Author(s):  
Julie-Anne Martyn ◽  
Ann Woolcock

Abstract Aboriginal and Torres Strait Islander health practitioners (Practitioners) have a broad scope of practice and play a pivotal role in addressing health disparities for Aboriginal and Torres Strait Islander people. Practitioners are required to maintain knowledge and skill levels to provide ongoing quality care. However, continuing education (CE) opportunities for Practitioners in regional areas are limited and little is known about the types of CE best suited to Practitioners. This study aimed to identify the CE needs of Practitioners working in a South-East Queensland region in Australia. Participatory action research and appreciative inquiry were combined in this multi-staged study. A local Aboriginal and Torres Strait Islander advisory group provided cultural guidance for the study design and implementation. Supervisors and Practitioners from two Aboriginal Medical Services consented to participate. In stage one of this study, the supervisors were interviewed and the Practitioners contributed to focus groups. The Practitioners prioritised their CE needs in the second study stage using a questionnaire. The participants identified Practitioner CE needs and group 2 listed their career aspirations and the best practitioners were described as ‘Deadly’. The Deadly practitioner had diverse practice knowledge, skills and attributes. The Practitioners had career aspirations beyond their role and a desire to learn. However, their career advancement was stifled by a lack of CE opportunities. CE in regional areas is limited. Practitioners are disadvantaged by exclusion. Enhancing CE opportunities for Practitioners will positively impact the health of regional Aboriginal and Torres Strait Islander communities by building social capital. Therefore, future research on Practitioner roles and CE is needed.


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