scholarly journals Integrated learning in a drug and alcohol university degree for Aboriginal and Torres Strait Islander adults: a case study

2018 ◽  
Vol 15 (1) ◽  
pp. 44-51
Author(s):  
KS Kylie Lee ◽  
Michelle Harrison ◽  
Scott Wilson ◽  
Warren Miller ◽  
Jimmy Perry ◽  
...  

Aboriginal and Torres Strait Islander (Indigenous) health professionals working in the alcohol and other drugs field perform a complex role in tackling substance misuse and related harms. Professional training and development opportunities for these “frontline” Indigenous alcohol and other drugs staff is key to prevent burnout and to allow them to work to their full potential. However, there are many barriers for those seeking to improve their skills. A number of teaching approaches have been described as important, but we were unable to identify peer-reviewed publications that detail the optimal approach to tailor university learning to meet the needs of Indigenous alcohol and other drugs health professionals. This article reflects on the experience of providing one such programme: a graduate diploma in Indigenous health and substance use, designed and delivered specifically for Aboriginal and Torres Strait Islander mature-aged students.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicole Freene ◽  
Roslyn Brown ◽  
Paul Collis ◽  
Chris Bourke ◽  
Katharine Silk ◽  
...  

Abstract Background There is limited evidence of Aboriginal and Torres Strait Islander people attending cardiac rehabilitation (CR) programs despite high levels of heart disease. One key enabler for CR attendance is a culturally safe program. This study evaluates improving access for Aboriginal and Torres Strait Islander women to attend a CR program in a non-Indigenous health service, alongside improving health workforce cultural safety. Methods An 18-week mixed-methods feasibility study was conducted, with weekly flexible CR sessions delivered by a multidisciplinary team and an Aboriginal and/or Torres Strait Islander Health Worker (AHW) at a university health centre. Aboriginal and Torres Strait Islander women who were at risk of, or had experienced, a cardiac event were recruited. Data was collected from participants at baseline, and at every sixth-session attended, including measures of disease risk, quality-of-life, exercise capacity and anxiety and depression. Cultural awareness training was provided for health professionals before the program commenced. Assessment of health professionals’ cultural awareness pre- and post-program was evaluated using a questionnaire (n = 18). Qualitative data from participants (n = 3), the AHW, health professionals (n = 4) and referrers (n = 4) was collected at the end of the program using yarning methodology and analysed thematically using Charmaz’s constant comparative approach. Results Eight referrals were received for the CR program and four Aboriginal women attended the program, aged from 24 to 68 years. Adherence to the weekly sessions ranged from 65 to 100%. At the program’s conclusion, there was a significant change in health professionals’ perception of social policies implemented to ‘improve’ Aboriginal people, and self-reported changes in health professionals’ behaviours and skills. Themes were identified for recruitment, participants, health professionals and program delivery, with cultural safety enveloping all areas. Trust was a major theme for recruitment and adherence of participants. The AHW was a key enabler of cultural authenticity, and the flexibility of the program contributed greatly to participant perceptions of cultural safety. Barriers for attendance were not unique to this population. Conclusion The flexible CR program in a non-Indigenous service provided a culturally safe environment for Aboriginal women but referrals were low. Importantly, the combination of cultural awareness training and participation in the program delivery improved health professionals’ confidence in working with Aboriginal people. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) 12618000581268, http://www.ANZCTR.org.au/ACTRN12618000581268.aspx, registered 16 April 2018.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Michelle Dickson

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.


2020 ◽  
pp. 108-114 ◽  
Author(s):  
Jennifer Chynoweth ◽  
Meaghan M. McCambridge ◽  
Helen M. Zorbas ◽  
Jacinta K. Elston ◽  
Robert J.S. Thomas ◽  
...  

PURPOSE To improve cancer outcomes for Aboriginal and Torres Strait Islander people through the development and national endorsement of the first population-specific optimal care pathway (OCP) to guide the delivery of high-quality, culturally appropriate, and evidence-based cancer care. METHODS An iterative methodology was undertaken over a 2-year period, and more than 70 organizations and individuals from diverse cultural, geographic, and sectorial backgrounds provided input. Cancer Australia reviewed experiences of care and the evidence base and undertook national public consultation with the Indigenous health sector and community, health professionals, and professional colleges. Critical to the OCP development was the leadership of Aboriginal and Torres Strait Islander health experts and consumers. RESULTS The OCP received unanimous endorsement by all federal, state, and territory health ministers. Key elements of the OCP include attention to the cultural appropriateness of the health care environment; improvement in cross-cultural communication; relationship building with local community; optimization of health literacy; recognition of men’s and women’s business; and the need to use culturally appropriate resources. The OCP can be used as a tool for health services and health professionals to identify gaps in current cancer services and to inform quality improvement initiatives across all aspects of the care pathway. CONCLUSION The development of the OCP identified a number of areas that require prioritization. Ensuring culturally safe and accessible health services is essential to support early presentation and diagnosis. Multidisciplinary treatment planning and patient-centered care are required for all Aboriginal and Torres Strait Islander people, irrespective of location. Health planners and governments acknowledge the imperative for change and have expressed strong commitment to work with Indigenous Australians to improve the accessibility, cultural appropriateness, and quality of cancer care.


Author(s):  
Helen Bnads ◽  
Elizabeth Orr ◽  
C John Clements

Abstract Aboriginal and Torres Strait Islanders have suffered violence and extreme prejudice in every walk of life as a result of the European colonisation of Australia. We acknowledge the ongoing colonial legacy to this suffering and discuss how cultural safety is a solution to overcoming some elements of the disadvantages that still beset Aboriginal and Torres Strait Islander people in terms of accessing health care. Accessible and culturally safe health services are critical in reducing health inequalities for First Nations’ people because of the burden of ill-health they experience. ‘Cultural safety’ in this context refers to approaches that strengthen and respectfully engage with Aboriginal and Torres Strait Islander cultures in mainstream services. Alongside holistic Indigenous health and primary prevention approaches, a broad range of medical, socio-cultural and allied health support is needed to alleviate these inequalities. In this article, we describe how the working relationship between Aboriginal Hospital Liaison Officers and Social Workers in public hospitals in Victoria, Australia, contributes to cultural safety, and thereby improves the quality of care and a reduction in discharges against medical advice by Aboriginal patients. We conclude that elements of this model may be applicable to improving care for First Nation peoples in other countries.


2021 ◽  
pp. 135581962110418
Author(s):  
Stephanie De Zilva ◽  
Troy Walker ◽  
Claire Palermo ◽  
Julie Brimblecombe

Objectives Culturally safe health care services contribute to improved health outcomes for Aboriginal and Torres Strait Islander Peoples in Australia. Yet there has been no comprehensive systematic review of the literature on what constitutes culturally safe health care practice. This gap in knowledge contributes to ongoing challenges providing culturally safe health services and policy. This review explores culturally safe health care practice from the perspective of Indigenous Peoples as recipients of health care in Western high-income countries, with a specific focus on Australian Aboriginal and Torres Strait Islander Peoples. Methods A systematic meta-ethnographic review of peer-reviewed literature was undertaken across five databases: Ovid MEDLINE, Scopus, PsychINFO, CINAHL Plus and Informit. Eligible studies included Aboriginal and Torres Strait Islander Peoples receiving health care in Australia, had a focus on exploring health care experiences, and a qualitative component to study design. Two authors independently determined study eligibility (5554 articles screened). Study characteristics and results were extracted and quality appraisal was conducted. Data synthesis was conducted using meta-ethnography methodology, contextualised by health care setting. Results Thirty-four eligible studies were identified. Elements of culturally safe health care identified were inter-related and included personable two-way communication, a well-resourced Indigenous health workforce, trusting relationships and supportive health care systems that are responsive to Indigenous Peoples’ cultural knowledge, beliefs and values. Conclusions These elements can form the basis of interventions and strategies to promote culturally safe health care practice and systems in Australia. Future cultural safety interventions need to be rigorously evaluated to explore their impact on Indigenous Peoples’ satisfaction with health care and improvements in health care outcomes.


2014 ◽  
Vol 20 (3) ◽  
pp. 285 ◽  
Author(s):  
Geoffrey K. P. Spurling ◽  
Deborah A. Askew ◽  
Philip J. Schluter ◽  
Fiona Simpson ◽  
Noel E. Hayman

Few epidemiological studies of middle ear disease have been conducted in Aboriginal and Torres Strait Islander populations, yet the disease is common and causes hearing impairment and poorer educational outcomes. The objective of this study is to identify factors associated with abnormal middle ear appearance, a proxy for middle ear disease. Aboriginal and Torres Strait Islander children aged 0–14 years receiving a Child Health Check (CHC) at an urban Indigenous Health Service, Brisbane, Australia were recruited from 2007 to 2010. Mixed-effects models were used to explore associations of 10 recognised risk factors with abnormal middle ear appearance at the time of the CHC. Ethical approval and community support for the project were obtained. Four hundred and fifty-three children were included and 54% were male. Participants were Aboriginal (92%), Torres Strait Islander (2%) or both (6%). Abnormal middle ear appearance was observed in 26 (6%) children and was significantly associated with previous ear infection (odds ratio (OR), 8.8; 95% confidence interval (CI), 3.2–24.0) and households with eight or more people (OR, 3.8; 95% CI, 1.1–14.1) in the imputed multivariable mixed-effects model. No significant associations were found for the other recognised risk factors investigated. Overcrowding should continue to be a core focus for communities and policy makers in reducing middle ear disease and its consequences in Aboriginal and Torres Strait Islander peoples.


2021 ◽  
Author(s):  
Sarah Jane PERKES

BACKGROUND Despite their growing popularity, there are very few mobile health (mHealth) interventions for Aboriginal and Torres Strait Islander people that are culturally safe and evidence-based. A co-design approach is considered a suitable methodology for developing health interventions with Aboriginal and Torres Strait Islander people. OBJECTIVE The aim of this study was to co-design a mHealth intervention to improve health knowledge, health behaviours, and access to health services for women caring for young Aboriginal and Torres Strait Islander children. METHODS Aboriginal researchers led engagement and recruitment with health services and participants in three Aboriginal communities in New South Wales Australia. Focus groups and interviews were facilitated by researchers and an app developer to gather information on three pre-determined themes, 1) design characteristics, 2) content modules, and 3) features and functions. Findings from the co-design led to the development of an intervention prototype. Theories of health behaviour change were used to underpin intervention components. Existing publicly available evidence-based information was used to develop content. Governance was provided by an Aboriginal Advisory group RESULTS Thirty-one mothers and 11 health professionals participated in eight co-design focus groups and 12 interviews from June to September 2019. Six design characteristics identified as important were: (1) Credibility, (2) Aboriginal and Torres Strait Islander designs and cultural safety, (3) Family centredness, (4) Supportive, (5) Simple to use, and (6) Confidential. Content modules include six modules for women’s health: (1) Smoke free families, (2) Safe drinking, (3) Feeling Good, (4) Women’s Business, (5) Eating, (6) Exercise; and six modules for children’s health: (1) Breathing Well, (2) Sleeping, (3) Milestones, (4) Feeding and Eating, (5) Vaccinations and Medicine, and (6) Ears, Eyes and Teeth. Six technology features and functions were also identified: (1) Content feed, (2) Social connection, (3) Reminders, (4) Rewards, (5) Communication with health professionals, and (6) Use of videos. CONCLUSIONS An mHealth intervention including app, Facebook page, and text message modalities was developed based on the co-design findings. The intervention incorporates health behaviour change theory, evidence-based information and the preferences of Aboriginal and Torres Strait Islander women and health professionals. A pilot study is now needed to assess the acceptability and feasibility of the intervention.


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