scholarly journals Study protocol: Yarning about HPV Vaccination: a qualitative study of factors influencing HPV vaccination among Aboriginal and Torres Strait Islander adolescents in Australia

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047890
Author(s):  
Lisa J Whop ◽  
Tamara L Butler ◽  
Julia M L Brotherton ◽  
Kate Anderson ◽  
Joan Cunningham ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Torres Strait Islander ◽  
Hpv Vaccination ◽  
Immunisation Programme ◽  
Ethics Committee ◽  
Research Approach ◽  
Indigenous Research ◽  
Vaccination Uptake ◽  
School Based ◽  
Torres Strait

IntroductionAboriginal and Torres Strait Islander women experience a higher burden of cervical cancer than non-Indigenous women in Australia. Cervical cancer is preventable partly through human papillomavirus (HPV) vaccination; in Australia, this is delivered through the national school-based immunisation programme. While HPV vaccination uptake is high among Australian adolescents, there remain gaps in uptake and completion among Aboriginal and Torres Strait Islander adolescents. This study aims to gain a comprehensive understanding of the barriers and facilitators to HPV vaccination uptake and completion among Aboriginal and Torres Strait Islander adolescents in Queensland, Australia.Methods and analysisThe study will be guided by an Indigenist research approach and an ecological model for health promotion. Yarning, a qualitative Indigenous research method, will be conducted in up to 10 schools. Participants will include Year 7 (12/13 years old) Aboriginal and Torres Strait Islander adolescents; parents/caregivers; and local key informants and immunisation programme partners involved in the delivery of school-based HPV immunisation programme. Participants will be recruited through school representatives and investigator networks using purposive and snowball sampling and samples of convenience. Field notes, HPV vaccination clinic observations and sequential diagramming of the HPV vaccination process will be conducted. Thematic analysis of data will be led by Aboriginal and Torres Strait Islander researchers. Synthesised sequential diagrams of the process of HPV vaccination and qualitative themes summarising key findings will be produced.Ethics and disseminationThe Aboriginal Health and Medical Research Council of New South Wales Ethics Committee (1646/20), the Australian National University Human Research Ethics Committee (HREC, 2020/478), the HREC of the Northern Territory Department of Health and Menzies School of Health Research (19-3484) and the Townsville Hospital and Health Service HREC (HREC/QTHS/73789) have approved the study. Dissemination will occur via conferences and peer-reviewed publications. Further dissemination will be determined in partnership with the Aboriginal and Torres Strait Islander Steering Committee, including Youth Representatives and Consultation Network.

scholarly journals Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia

2019 ◽  
Vol 16 (19) ◽  
pp. 3630 ◽  
Author(s):  
Abbey Diaz ◽  
Brenda Vo ◽  
Peter D. Baade ◽  
Veronica Matthews ◽  
Barbara Nattabi ◽  
...  
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Primary Health Care ◽  
Torres Strait Islander ◽  
Cervical Screening ◽  
Service Level ◽  
Factors Associated ◽  
Primary Health ◽  
Screening Coverage ◽  
Torres Strait

Aboriginal and Torres Strait Islander women have significantly higher cervical cancer incidence and mortality than other Australian women. In this study, we assessed the documented delivery of cervical screening for women attending Indigenous Primary Health Care (PHC) centres across Australia and identified service-level factors associated with between-centre variation in screening coverage. We analysed 3801 clinical audit records for PHC clients aged 20–64 years from 135 Indigenous PHC centres participating in the Audit for Best Practice in Chronic Disease (ABCD) continuous quality improvement (CQI) program across five Australian states/territories during 2005 to 2014. Multilevel logistic regression models were used to identify service-level factors associated with screening, while accounting for differences in client-level factors. There was substantial variation in the proportion of clients who had a documented cervical screen in the previous two years across the participating PHC centres (median 50%, interquartile range (IQR): 29–67%), persisting over years and audit cycle. Centre-level factors explained 40% of the variation; client-level factors did not reduce the between-centre variation. Screening coverage was associated with longer time enrolled in the CQI program and very remote location. Indigenous PHC centres play an important role in providing cervical screening to Aboriginal and Torres Strait Islander women. Thus, their leadership is essential to ensure that Australia’s public health commitment to the elimination of cervical cancer includes Aboriginal and Torres Strait Islander women. A sustained commitment to CQI may improve PHC centres delivery of cervical screening; however, factors that may impact on service delivery, such as organisational, geographical and environmental factors, warrant further investigation.

scholarly journals “My work? Well, I live it and breathe it”: The seamless connect between the professional and personal/community self in the Aboriginal and Torres Strait Islander health sector

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Michelle Dickson
Keyword(s):  
Health Worker ◽  
Health Professionals ◽  
Torres Strait Islander ◽  
Health Workers ◽  
Health Sector ◽  
Indigenous Research ◽  
Indigenous Australian ◽  
Team Members ◽  
Torres Strait ◽  
Torres Strait Islander Health

Abstract Background Australian Aboriginal and Torres Strait Islander health professionals often juggle the challenges of working and living in the same community in ways that are positive for both themselves and their clients. This study specifically examines the strategies Aboriginal and Torres Strait Islander health professionals have developed to enable them to feel empowered by the sense of being always visible or perceived as being always available. Findings provide examples of how participants (Team Members) established a seamless working self, including how they often held different perspectives to many work colleagues, how Team Members were always visible to community and how Team Members were comfortable to be seen as working when not at work. Methods This qualitative study engages an Indigenous research methodology and uses an Indigenous method, PhotoYarning, to explore lived experiences of a group (n = 15) of Aboriginal and Torres Strait Islander health workers as they worked in the Australian health sector. Results The analysis presented here comes from data generated through PhotoYarning sessions. Team Members in this study all work in health care settings in the communities in which they also live, they manage an extremely complex network of interactions and relationships in their daily working lives. They occupy an ambivalent, and sometimes ambiguous, position as representing both their health profession and their community. This article explores examples of what working with seamlessness involved, with findings citing four main themes: (1) Being fellow members of their cultural community, (2) the feeling of always being visible to community as a health worker, (3) the feeling of always being available as a health worker to community even when not at work and (4) the need to set an example. Conclusions While creating the seamlessness of working and living in the same community was not easy, Team Members considered it an important feature of the work they did and vital if they were to be able to provide quality health service to their community. However, they reported that the seamless working self was at odds with the way many of their non-Indigenous Australian colleagues worked and it was not well understood.

A review of school trauma-informed practice for Aboriginal and Torres Strait Islander children and youth

2020 ◽  
Vol 37 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Jenna Miller ◽  
Emily Berger
Keyword(s):  
Torres Strait Islander ◽  
Children And Young People ◽  
School Based ◽  
School Programs ◽  
Trauma Informed ◽  
School Based Interventions ◽  
Torres Strait ◽  
Trauma Informed Practice ◽  
Key Aspects ◽  
Historical Issues

AbstractAboriginal and Torres Strait Islander people in Australia are especially vulnerable to traumatic and discriminatory experiences. However, limited literature and research has implemented and evaluated school-based interventions designed to assist Aboriginal and Torres Strait Islander children and young people to overcome their adversity and achieve their potential at school. This article reviews the literature and frameworks on school programs designed for Aboriginal and Torres Strait Islander students who have experienced trauma. The key aspects of trauma-informed programs in schools for Aboriginal and Torres Strait Islander students is explored and recommendations made for further research and greater acknowledgement of cultural and historical issues for Aboriginal and Torres Strait Islander students when implementing culturally informed and trauma-informed practices in schools.

scholarly journals Effects of Nutritional Interventions on Cardiovascular Disease Health Outcomes in Aboriginal and Torres Strait Islander Australians: A Scoping Review

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4084
Author(s):  
Bobby Porykali ◽  
Alyse Davies ◽  
Cassandra Brooks ◽  
Hannah Melville ◽  
Margaret Allman-Farinelli ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Health Outcomes ◽  
Torres Strait Islander ◽  
Grey Literature ◽  
Indigenous Research ◽  
Quality Appraisal ◽  
Nutritional Interventions ◽  
Nutrition Programs ◽  
Torres Strait ◽  
Appraisal Tool

Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components.

Indigenous Research: Three Researchers Reflect on their Experiences at the Interface

2007 ◽  
Vol 36 (S1) ◽  
pp. 23-31 ◽  
Author(s):  
Deanne Minniecon ◽  
Naomi Franks ◽  
Maree Heffernan
Keyword(s):  
Higher Education ◽  
Torres Strait Islander ◽  
Standpoint Theory ◽  
Indigenous Research ◽  
Research Project ◽  
Cultural Interface ◽  
Research Questions ◽  
Torres Strait

AbstractUtilising Nakata’s (2007) description of the “cultural interface”, two Indigenous researchers and one non-Indigenous researcher examine their development of Indigenous research in and with Aboriginal and Torres Strait Islander communities conducted from within an institution of higher education. The authors reflect on their experiences in developing an Indigenous research project and use Indigenous standpoint theory as a device to explore these experiences. The framing of priorities and research questions, ethics processes, the treatment of project information or data, the managing of competing accountabilities, and the role of non-Indigenous researchers in Indigenous research are all explored in these reflections.

Burn Injuries in Hospitalized Australian Children—An Epidemiological Profile

2020 ◽  
Author(s):  
Courtney Ryder ◽  
Tamara Mackean ◽  
Kate Hunter ◽  
Kris Rogers ◽  
Andrew J A Holland ◽  
...  
Keyword(s):  
First Nations ◽  
Torres Strait Islander ◽  
Total Body Surface Area ◽  
Health Inequities ◽  
Hospital Length ◽  
Burn Injuries ◽  
Hospital Length Of Stay ◽  
Indigenous Research ◽  
Torres Strait ◽  
Epidemiological Profile

Abstract Globally, First Nations children sustain burns at a higher rate than other children. Little is understood about how health inequities contribute, especially from an Indigenous viewpoint. We analyzed data from the Burns Registry of Australian and New Zealand (BRANZ) for acute burns in children (<16 years) admitted to hospital between October 2009 and July 2018. Descriptive statistics examined equity variables in patient and injury characteristics. Poisson regression was used to describe factors associated with bacterial infection. Indigenous research methods were used throughout. Aboriginal and Torres Strait Islander children represented 10.4% of the study population. Health inequities were present for Aboriginal and Torres Strait Islander children with longer hospital length of stay (9.5 vs 4.6 days), rural residency (61.3% vs 13.9%), lower socioeconomic status (72.2% vs 34.9%), and more flame burns (19.5% vs 10.6%) compared to other Australian children. Streptococcus sp. infection risk was four times greater in Aboriginal and Torres Strait Islander children compared to other Australian children. Flame burns and high percentage total body surface area burns were a risk for Staphylococcus sp. and Streptococcus sp. infection in all children. The epidemiological profile for burn injuries managed in Australian burns centers differs between Aboriginal and Torres Strait Islander children and other children, indicating persistent health inequities. These differences should be considered in the development of injury prevention strategies and the clinical management of burn injuries for Aboriginal and Torres Strait Islander children and their families.

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

2021 ◽  
Vol 18 (12) ◽  
pp. 6193
Author(s):  
Gail Garvey ◽  
Kate Anderson ◽  
Alana Gall ◽  
Tamara L. Butler ◽  
Joan Cunningham ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Large Scale ◽  
Torres Strait Islander ◽  
Evidence Base ◽  
Holistic Health ◽  
Research Approach ◽  
Torres Strait Islander People ◽  
Torres Strait ◽  
And Control ◽  
Health Purpose

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.

scholarly journals Nurses’ and teachers’ perceived barriers and facilitators to the uptake of the Human Papilloma Virus (HPV) vaccination program in Iquitos, Peru: A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255218
Author(s):  
Anna Clavé Llavall ◽  
Gilles de Wildt ◽  
Graciela Meza ◽  
Jasmine Tattsbridge ◽  
Laura Jones
Keyword(s):  
Cervical Cancer ◽  
Community Education ◽  
Ecological Model ◽  
Hpv Vaccination ◽  
Barriers And Facilitators ◽  
Vaccine Uptake ◽  
Vaccination Program ◽  
Papilloma Virus ◽  
Vaccination Uptake ◽  
Depth Interviews

Globally, over 300,000 women die of cervical cancer annually. Given that human papillomavirus vaccines are highly effective in the primary prevention of cervical cancer, it is important to explore the barriers and facilitators to vaccination uptake in areas where the burden of disease remains high. This study, informed by the socio-ecological model, aimed to qualitatively explore vaccination uptake via in-depth interviews with eleven nurses and ten teachers involved in vaccine delivery in Iquitos, Peru. The results highlighted that vaccine uptake was influenced by multiple factors including individuals’ knowledge and attitudes, community beliefs, geography, and policy level variables. Findings suggested that professionals were informed and supportive of the HPV vaccination program but perceived that parents were uninformed about the vaccine. There is a need for community education programs, for a revision of the process of obtaining parental consent, for improved communication between professionals and for involvement of grassroots staff in policy making.

scholarly journals Evaluation of a School-Based Cervical Cancer Vaccination Awareness Initiative

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 136s-136s
Author(s):  
O. James ◽  
O. Onigbogi ◽  
I. Okoye
Keyword(s):  
Cervical Cancer ◽  
Quantitative Methods ◽  
Hpv Vaccination ◽  
Effective Strategy ◽  
Hpv Vaccines ◽  
Nigerian Women ◽  
Vaccination Uptake ◽  
School Aged Children ◽  
Out Of Pocket Payments ◽  
School Heads

Background and context: Cervical cancer is the second most commonly-diagnosed cancer among Nigerian women, even though it is one of the most highly-preventable cancers. Worldwide, this most populated country in Africa ranks 10th in terms of cervical cancer mortality and 7 of every 10 Nigerian women diagnosed with cervical cancer annually die annually. With about 47.72 million women aged 15 years and above who are at risk for cervical cancer and median age of first sexual intercourse being 16 years, there is a huge opportunity to prevent cervical cancer deaths through HPV vaccination. Unfortunately, Nigeria has been unable to access GAVI funding for implementation of country-wide HPV vaccination. Hence, most of the HPV vaccination has been by the private sector, NGOs/CSOs and through out-of pocket payments. In spite of this, uptake of HPV vaccines have been reported to be as low as 8% in some studies. Aim: To determine the barriers to uptake of HPV vaccination among mothers of school-age children and opportunities to increase the uptake from the perspective of mothers. Strategy/Tactics: Use qualitative and quantitative methods to gather relevant information about HPV vaccination uptake from all stakeholders including school heads, teachers, school nurses, mothers/guardians and school associations. Program/Policy process: Through funds provided by the American Cancer Society (ACS) and GlaxoSmithkline, Nigeria, we had a one-day HPV vaccination awareness program targeted at school heads, distributed HPV vaccination consent forms, followed-up with awareness in school PTA meetings, gathered data through questionnaires, FGD and KII after a year to determine project effectiveness. Outcomes: Increased understanding of motivators and demotivating factors of HPV vaccination uptake among mothers of school-aged children, increased understanding of strategies to increase uptake and identification of allies in HPV vaccination advocacy. What was learned: 1. There is a need for consistent, “360 campaign” about HPV vaccination as an effective strategy for prevention of cervical cancer targeted at mothers. 2. Since government at federal and state level is unable to access GAVI funding for HPV vaccination, they do have a role to play in validating the effectiveness and safety of HPV vaccines, as well as the efforts of CSOs and NGOs to encourage parents to consent to HPV vaccination for their children. 3. Working in partnership with school associations could be an effective strategy to increasing HPV vaccination uptake among school-aged children. 4. Female teachers are viable advocates for increasing HPV vaccination uptake in schools, if their knowledge is increased and advocacy tools are provided. 5. There is a possibility that reluctance by the government to incorporate awareness of HPV vaccination into its cervical cancer prevention programs is due to its inability to meet the anticipated demand for free HPV vaccination.

scholarly journals Human Papillomavirus and Oropharyngeal Cancer Among Indigenous Australians: Protocol for a Prevalence Study of Oral-Related Human Papillomavirus and Cost-Effectiveness of Prevention (Preprint)

2018 ◽  
Author(s):  
Lisa Jamieson ◽  
Gail Garvey ◽  
Joanne Hedges ◽  
Amanda Mitchell ◽  
Terry Dunbar ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cost Effectiveness ◽  
High Risk ◽  
Oropharyngeal Cancer ◽  
Torres Strait Islander ◽  
Hpv Vaccination ◽  
Health State ◽  
Torres Strait ◽  
The Impact

BACKGROUND Oropharyngeal cancer is an important, understudied cancer affecting Aboriginal and Torres Strait Islander Australians. The human papillomavirus (HPV) is a significant risk factor for oropharyngeal cancer. Current generation HPV vaccines are effective against the 2 most common types of high-risk HPVs in cancer (hrHPVs 16/18). OBJECTIVES This study aims (1) to yield population estimates of oncogenic genotypes of HPV in the mouth and oropharynx of defined Aboriginal and Torres Strait Islander populations; (2) to estimate the proportion of oropharyngeal cancer attributable to HPV among these Australian citizens; (3) to estimate the impact of HPV vaccination as currently implemented on rates of oropharyngeal cancer among Aboriginal and Torres Strait Islander Australians; and (4) taking into account impact on oropharyngeal as well as cervical cancer, to evaluate efficacy and cost-effectiveness of targeted extended HPV vaccination to older ages, among our study population. METHODS Our study design and operation is straightforward, with minimal impost on participants. It involves testing for carriage of hrHPV in the mouth and oropharynx among 1000 Aboriginal South Australians by simple saliva collection and with follow-up at 12 and 24 months, collection of sexual history at baseline, collection of information for estimating health state (quality-of-life) utilities at baseline, genotyping of viruses, predictive outcome and cost-effectiveness modeling, data interpretation and development of vaccination, and follow-up management strategies driven by the Aboriginal community. RESULTS Participant recruitment for this study commenced in February 2018 and enrollment is ongoing. The first results are expected to be submitted for publication in 2019. CONCLUSIONS The project will have a number of important outcomes. Synthesis of evidence will enable generation of estimates of the burden of oropharyngeal cancer among Aboriginal and Torres Strait Islander Australians and indicate the likely effectiveness and cost-effectiveness of prevention. This will be important for health services planning, and for Aboriginal health worker and patient education. The results will also point to important areas where research efforts should be focused to improve outcomes in Aboriginal and Torres Strait Islander Australians with oropharyngeal cancer. There will be a strong focus on community engagement and accounting for the preferences of individuals and the community in control of HPV-related cancers. The project has international relevance in that it will be the first to systematically evaluate prevention of both cervical and oropharyngeal cancer in a high-risk Indigenous population taking into account all population, testing, and surveillance options. REGISTERED REPORT IDENTIFIER RR1-10.2196/10503

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