scholarly journals Rigorous follow-up systems for abnormal results are essential to improve health outcomes for Aboriginal and Torres Strait Islander people

2018 ◽  
Vol 24 (1) ◽  
pp. 1 ◽  
Author(s):  
Jodie Bailie ◽  
Veronica Matthews ◽  
Alison Laycock ◽  
Christine Connors ◽  
Ross Bailie
Keyword(s):  
Health Outcomes ◽  
Torres Strait Islander ◽  
Torres Strait Islander People ◽  
Torres Strait ◽  
Improve Health ◽  
Abnormal Results

scholarly journals The effectiveness of Ear Nose and Throat outreach programs for Aboriginal and Torres Strait Islander Australians: a systematic review

2020 ◽  
Author(s):  
Anna Gotis-Graham ◽  
Rona Macniven ◽  
Kelvin Kong ◽  
Kylie Gwynne
Keyword(s):  
Health Outcomes ◽  
Torres Strait Islander ◽  
List Type ◽  
Torres Strait Islander People ◽  
Outreach Programs ◽  
Outreach Services ◽  
Torres Strait ◽  
The Impact ◽  
Nose And Throat ◽  
Improve Health

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

scholarly journals Effectiveness of ear, nose and throat outreach programmes for Aboriginal and Torres Strait Islander Australians: a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038273
Author(s):  
Anna Gotis-Graham ◽  
Rona Macniven ◽  
Kelvin Kong ◽  
Kylie Gwynne
Keyword(s):  
Health Outcomes ◽  
Torres Strait Islander ◽  
Assessment Tool ◽  
Grey Literature ◽  
Torres Strait Islander People ◽  
Outreach Services ◽  
Torres Strait ◽  
The Impact ◽  
Nose And Throat ◽  
Improve Health

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.

scholarly journals Baseline liver function tests and full blood count indices and their association with progression of chronic kidney disease and renal outcomes in Aboriginal and Torres Strait Islander people: the eGFR follow- up study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Sandawana William Majoni ◽  
Federica Barzi ◽  
Wendy Hoy ◽  
Richard J. MacIsaac ◽  
Alan Cass ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Torres Strait Islander ◽  
Blood Count ◽  
Liver Function Tests ◽  
Full Blood Count ◽  
Torres Strait Islander People ◽  
Renal Outcomes ◽  
Torres Strait ◽  
Annual Decline

Abstract Background Determination of risks for chronic kidney disease (CKD) progression could improve strategies to reduce progression to ESKD. The eGFR Study recruited a cohort of adult Aboriginal and Torres Strait Islander people (Indigenous Australians) from Northern Queensland, Northern Territory and Western Australia, aiming to address the heavy CKD burden experienced within these communities. Methods Using data from the eGFR study, we explored the association of baseline liver function tests (LFTs) (alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), bilirubin and albumin) and full blood count (FBC) indices (white blood cell and red blood cell counts and haemoglobin) with annual eGFR decline and renal outcomes (first of 30% decline in eGFR with a follow-up eGFR < 60 mL/min/1.73 m2, initiation of renal replacement therapy, or renal death). Comparisons of baseline variables across eGFR categories were calculated using analysis of variance and logistic regression as appropriate. Linear and multivariable regression models were used to estimate the annual change in eGFR for changes in FBC indices and LFTs. Cox proportional hazard models were used to estimate the hazard ratio for developing renal outcome for changes in baseline FBC indices and LFTs. Results Of 547 participants, 540 had at least one baseline measure of LFTs and FBC indices. The mean age was 46.1 (14.7) years and 63.6% were female. The median follow-up was 3.1 (IQR 2.8–3.6) years. Annual decline in eGFR was associated with low serum albumin (p < 0.001) and haemoglobin (p = 0.007). After adjustment for age, gender, urine albumin/creatinine ratio, diabetes, BMI, CRP, WHR, alcohol consumption, cholesterol and triglycerides, low serum albumin (p < 0.001), haemoglobin (p = 0.012) and bilirubin (p = 0.011) were associated with annual decline in eGFR. Renal outcomes were inversely associated with serum albumin (p < 0.001), bilirubin (p = 0.012) and haemoglobin (p < 0.001) and directly with GGT (p = 0.007) and ALP (p < 0.001). Other FBC indices and LFTs were not associated with annual decline in eGFR or renal outcomes. Conclusions GGT, ALP, bilirubin, albumin and haemoglobin independently associate with renal outcomes. Contrary to findings from other studies, no association was found between renal outcomes and other FBC indices. These findings may help focus strategies to prevent disease progression in this high-risk population.

scholarly journals Getting A Job

2009 ◽  
Vol 2 (1) ◽  
pp. 24-35 ◽  
Author(s):  
Bronwyn Fredericks
Keyword(s):  
Health Outcomes ◽  
Indigenous People ◽  
Torres Strait Islander ◽  
Health Sector ◽  
Self Esteem ◽  
Torres Strait Islander People ◽  
Aboriginal Women ◽  
Education Levels ◽  
Indigenous Participation ◽  
Torres Strait

Indigenous participation in employment has long been seen as an indicator of Indigenous economic participation in Australia. Researchers have linked participation in employment to improved health outcomes, increased education levels and greater self-esteem. There has been a dramatic increase in the number of Indigenous workforce policies and employment strategies as employers and industries attempt to employ more Aboriginal and Torres Strait Islander people. Coupled with this has been a push to employ more Indigenous people in specific sectors to address the multiple layers of disadvantage experienced by Indigenous people, for example, the health sector. This paper draws on interview discussions with Aboriginal women in Rockhampton, Central Queensland, along with findings from the research of others to offer a greater understanding of the mixed benefits of increased Indigenous employment. What is demonstrated is that the nature of Indigenous employment is complex and not as simple as ‘just getting a job’.

scholarly journals Interventions to improve health literacy among Aboriginal and Torres Strait Islander Peoples: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Simone Nash ◽  
Amit Arora
Keyword(s):  
Systematic Review ◽  
Health Literacy ◽  
Health Outcomes ◽  
Torres Strait Islander ◽  
Cochrane Library ◽  
Indigenous Australians ◽  
Community Members ◽  
Indigenous Australian ◽  
Torres Strait ◽  
Improve Health

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.

scholarly journals The research road less travelled

2009 ◽  
Vol 30 (5) ◽  
pp. 169
Author(s):  
Mick Gooda
Keyword(s):  
Health Outcomes ◽  
Indigenous Peoples ◽  
Biomedical Research ◽  
Torres Strait Islander ◽  
Health It ◽  
Torres Strait ◽  
Torres Strait Islander Health ◽  
Improve Health

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.

scholarly journals Baseline liver function tests and full blood count indices and their association with progression of chronic kidney disease and renal outcomes in Aboriginal and Torres Strait Islander people: the eGFR Follow- up Study 

2020 ◽  
Author(s):  
Sandawana William Majoni ◽  
Federica Barzi ◽  
Wendy Hoy ◽  
Richard MacIsaac J MacIsaac ◽  
Alan Cass Cass ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Torres Strait Islander ◽  
Blood Count ◽  
Liver Function Tests ◽  
Full Blood Count ◽  
Torres Strait Islander People ◽  
Renal Outcomes ◽  
Torres Strait ◽  
Annual Decline

Abstract Background: Determination of risks for chronic kidney disease (CKD) progression could improve strategies to reduce progression to ESKD. The eGFR Study recruited a cohort of adult Aboriginal and Torres Strait Islander people (Indigenous Australians) from Northern Queensland, Northern Territory and Western Australia, aiming to address the heavy CKD burden experienced within these communities.Methods: Using data from the eGFR study, we explored the association of baseline liver function tests (LFTs) (alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), bilirubin and albumin) and full blood count (FBC) indices (white blood cell and red blood cell counts and haemoglobin) with annual eGFR decline and renal outcomes (first of 30% decline in eGFR with a follow-up eGFR <60 mL/min/1.73 m2, initiation of renal replacement therapy, or renal death). Comparisons of baseline variables across eGFR categories were calculated using analysis of variance and logistic regression as appropriate. Linear and multivariable regression models were used to estimate the annual change in eGFR for changes in FBC indices and LFTs. Cox proportional hazard models were used to estimate the hazard ratio for developing renal outcome for changes in baseline FBC indices and LFTs.Results: Of 547 participants, 540 had at least one baseline measure of LFTs and FBC indices. The mean age was 46.1 (14.7) years and 63.6% were female. The median follow-up was 3.1 (IQR 2.8-3.6) years. Annual decline in eGFR was associated with low serum albumin (p<0.001) and haemoglobin (p=0.007). After adjustment for age, gender, urine albumin/creatinine ratio, diabetes, BMI, CRP, WHR, alcohol consumption, cholesterol and triglycerides, low serum albumin (p<0.001), haemoglobin (p=0.012) and bilirubin (p=0.011) were associated with annual decline in eGFRRenal outcomes were inversely associated with serum albumin (p<0.001), bilirubin (p=0.012) and haemoglobin (p<0.001) and directly with GGT (p=0.007) and ALP (p<0.001). Other FBC indices and LFTs were not associated with annual decline in eGFR or renal outcomes.Conclusions: GGT, ALP, bilirubin, albumin and haemoglobin independently associate with renal outcomes. Contrary to findings from other studies, no association was found between renal outcomes and other FBC indices. These findings may help focus strategies to prevent disease progression in this high-risk population.

scholarly journals Effect of nutrition interventions on diet-related and health outcomes of Aboriginal and Torres Strait Islander Australians: a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025291 ◽  
Author(s):  
Josephine Gwynn ◽  
Kyra Sim ◽  
Tania Searle ◽  
Alistair Senior ◽  
Amanda Lee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Community Engagement ◽  
Urban Communities ◽  
Torres Strait Islander ◽  
Nutrition Interventions ◽  
Torres Strait Islander People ◽  
Remote Communities ◽  
Australian Aboriginal ◽  
Torres Strait

ObjectiveTo review the literature on nutrition interventions and identify which work to improve diet-related and health outcomes in Australian Aboriginal and Torres Strait Islander people.Study designSystematic review of peer-reviewed literature.Data sourcesMEDLINE, PubMed, Embase, Science Direct, CINAHL, Informit, PsychInfo and Cochrane Library, Australian Indigenous Health InfoNet.Study selectionPeer-reviewed article describing an original study; published in English prior to December 2017; inclusion of one or more of the following outcome measures: nutritional status, food/dietary/nutrient intake, diet-related biomedical markers, anthropometric or health measures; and conducted with Australian Aboriginal and Torres Strait Islander people.Data extraction and synthesisTwo independent reviewers extracted data and applied the Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project. A purpose designed tool assessed community engagement in research, and a framework was applied to interventions to report a score based on numbers of settings and strategies. Heterogeneity of studies precluded a meta-analysis. The effect size of health outcome results were estimated and presented as forest plots.ResultsThirty-five articles (26 studies) met inclusion criteria; two rated moderate in quality; 12 described cohort designs; 18 described interventions in remote/very remote communities; none focused solely on urban communities; and 11 reported moderate or strong community engagement. Six intervention types were identified. Statistically significant improvements were reported in 14 studies of which eight reported improvements in biochemical/haematological markers and either anthropometric and/or diet-related outcomes.ConclusionsStore-based intervention with community health promotion in very remote communities, fiscal strategies and nutrition education and promotion programmes show promise. Future dietary intervention studies must be rigorously evaluated, provide intervention implementation details explore scale up of programmes, include urban communities and consider a multisetting and strategy approach. Strong Aboriginal and Torres Strait Islander community engagement is essential for effective nutrition intervention research and evaluation.PROSPERO registration numberCRD42015029551.

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