scholarly journals Defining a study population using enhanced reporting of Aboriginality and the effects on study outcomes

Author(s):  
Carol Anne McInerney ◽  
Ibinabo Ibiebele ◽  
Siranda Torvaldsen ◽  
Jane B Ford ◽  
Jonathan M Morris ◽  
...  

Introduction The under-ascertainment of Aboriginal and Torres Strait Islander status on routinely collected health datasets has important implications for understanding the health of this population. By pooling available information on individuals’ Aboriginal or Torres Strait Islander status from probabilistically linked datasets, methods have been developed to adjust for this under-recording. Objectives To explore different algorithms that enhance reporting of Aboriginal status in birth data to define a cohort of Aboriginal women, examine any differences between women recorded as Aboriginal and those assigned enhanced Aboriginal status, and assess the effects of using different reported populations to estimate within-group comparisons for Aboriginal people. Methods Three algorithms, with different levels of inclusiveness, were used to establish different study populations all of which aimed to include all singleton babies born to Aboriginal or Torres Strait Islander women residing in New South Wales, Australia between 2010 and 2014 and their mothers. The demographics of the four study populations were described and compared using frequencies and percentages. In order to assess the impact on research outcomes and conclusions of using study populations derived from different algorithms, estimates of the associations between smoking during pregnancy and selected perinatal outcomes were compared using rates and relative risks. Results Women included in the study population through enhanced reporting were older, less disadvantaged and more commonly resided in urban areas than those recorded as Aboriginal in the birth data. Although rates of smoking and some perinatal outcomes differed between the different study populations, the relative risks of each outcome comparing smoking and non-smoking Aboriginal mothers were very similar when estimated from each of the study populations. Conclusion This work provides evidence that estimates of within-group relative risks are reliable regardless of the assumptions made for establishing the study population through the enhanced reporting of indigenous peoples.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bobby Porykali ◽  
Patricia Cullen ◽  
Kate Hunter ◽  
Kris Rogers ◽  
Melissa Kang ◽  
...  

Abstract Background With increasingly tough graduated driver licensing laws in all Australian States and Territories, driver licensing support programs are recognised as being important to support Aboriginal and Torres Strait Islander peoples to obtain a driver licence. Such programs appear to improve licensing attainment rates, but few studies have examined the broader impact that these programs can have. This research aims to 1) examine the impact of a New South Wales (NSW) based driver licensing support program (Driving Change) on client employment outcomes; 2) assess the influence of geographical area of program delivery on driver licence attainment. Methods Driving Change was delivered from February 2013 to August 2016 in 4 urban and 7 regional Aboriginal communities of NSW. Clients were followed-up at 6 months or more following contact with the program as part of routine program operations. Descriptive statistics and regression models were used to analyse data. Results From 933 clients contacted 254 agreed to provide feedback, a response rate of 27%. Those that responded were mostly female (57%), aged 24 years and under (72%), unemployed (85%) with secondary education or less (71%) and from a regional area (74%). Adjusted logistic regression indicated that clients who achieved an independent licence were more likely (OR: 2.5, 95% CI: 1.22–5.24, p = 0.011) of reporting a new job or change in job than those who did not attain a licence. Clients from regional areas were more likely (OR: 1.72, 95% CI: 1.27–2.33, p < 0.001) to gain an independent licence than those from urban areas. There was no difference in employment outcomes (OR: 1.2, 95% CI: 0.53–2.52, p = 0.719) for clients from urban compared to regional areas. Conclusion The Driving Change program appears to be effective in improving employment outcomes for those who gained a licence. Clients from regional areas were more likely to gain a licence compared to those in urban settings, and were predominantly young and unemployed, often a hard to reach cohort. Future licensing programs being delivered in regional areas need integrated pathways into employment opportunities to provide holistic services that address the social and economic challenges faced by Aboriginal and Torres Strait Islander Australians.


2014 ◽  
Vol 43 (2) ◽  
pp. 218-230 ◽  
Author(s):  
Annabelle Wilson

It is well recognised that research with Aboriginal communities needs to be ethical, meaningful and useful, in a way that is defined by communities themselves. This article provides an example of how reflexivity, from a number of positions and paradigms, can be used to undertake such research. I used a reflexive journal to document and critically assess the challenges and discomfort I experienced while undertaking research with Aboriginal communities, including uncertainty and feeling in the minority. Reflexivity allowed me to experience a number of key learnings, including: the importance of relationships; the importance of time, transparency and trust in relationships; reciprocity; the importance of listening; a partnership approach; and the impact of Aboriginal culture and past experience. The way in which I redefined my success as a researcher is also explored. In using reflexivity I reached new levels of understanding about myself, which enabled me to alter my practice and therefore change the experiences of those I was working with, ideally towards experiences that were perceived as culturally safe. Using reflexivity also enabled me to identify my position as a White researcher and centralise the needs and perspectives of Aboriginal people in my research. The purpose of this article is to present my own journey, as well as start a dialogue and provide a framework for how others might use reflexivity to become a culturally safe health professional or researcher and centralise the needs and perspectives of Aboriginal people in research and practice.


Author(s):  
Bridgette J McNamara ◽  
Jocelyn Jones ◽  
Carrington CJ Shepherd ◽  
Lina Gubhaju ◽  
Grace Joshy ◽  
...  

Background In the ongoing debate on optimum methods for identification of Indigenous people within linked administrative data, few studies have examined the impacts of method on population counts and outcomes in family-based linkage studies of Aboriginal children. Objective To quantify differences between three validated algorithms in ascertaining Aboriginal and Torres Strait Islander children in linked administrative data. Methods Linked administrative health data for children born in WA from 2000-2013, were used to examine the cohorts identified by three methods: A) the Indigenous Status Flag (ISF, derived by the WA Data Linkage Branch using a multistage-median approach) for the children alone; B) the ISF of the children, their parents and grandparents; and C) Indigenous status of the child, mother or father on either of the child’s perinatal records (Midwives or birth registration), to determine differing characteristics of each cohort. Results Method B established a larger cohort (33,697) than Method C (33,510) and Method A (27,482), with all methods identifying a core group of 26,993 children (80-98%). Compared with children identified by Method A, additional children identified by Methods B or C, were from less-disadvantaged and more urban areas, and had better perinatal outcomes (e.g. lower proportions of small-for-gestational age, 10% vs 16%). Differences in demographics and health outcomes between Methods C and B were minimal. Conclusions Demographic and perinatal health characteristics differ by Indigenous identification method. Using perinatal records or the ISF of parents and grandparents (in addition to the ISF of the child) appear to be more inclusive methods for identifying young Indigenous children in administrative datasets.


2021 ◽  
Author(s):  
Bobby Porykali ◽  
Patricia Cullen ◽  
Kate Hunter ◽  
Kris Rogers ◽  
Melissa Kang ◽  
...  

Abstract Background: With increasingly tough graduated driver licensing laws in all Australian States and Territories, driver licensing support programs are recognised as being important to support Aboriginal and Torres Strait Islander peoples to obtain a driver licence. Such programs appear to improve licensing attainment rates, but few studies have examined the broader impact that these programs can have. This research aims to examine the impact of a NSW based driver licensing support program (Driving Change) on client employment outcomes. Methods: Driving Change was delivered from February 2013 to August 2016 in 4 urban and 7 regional Aboriginal communities of New South Wales. Clients were followed-up at 6 months or more following contact with the program as part of routine program operations. Descriptive statistics and regression models were used to analyse data.Results: From 933 clients contacted 254 agreed to provide feedback, a response rate of 27%. Those that responded were mostly female (57%), aged 24 years and under (72%), unemployed (85%) with secondary education or less (71%) and from a regional area (74%). Adjusted logistic regression indicated that clients who achieved an independent licence were more likely (OR: 2.5, 95% CI: 1.22 – 5.24, p=0.001) of reporting a new job or change in job than those who did not attain a licence. Clients from regional areas were more likely (OR: 1.72, 95% CI: 1.27 – 2.33, p=0.001) to gain an independent licence than those from urban areas. Clients from regional areas were also more likely to report an improvement in employment outcomes (OR: 1.2, 95% CI: 0.52 – 2.52, p=0.72,) compared to those from urban areas, though results were not statistically significant. Discussion: This licensing support program increased licensing attainment particularly in regional areas and also had a beneficial effect on employment for those who gained a licence through the program. Clients were predominantly young and unemployed, which are often a hard to reach cohort. There is a need for future licensing programs to collect client employment data and explore approaches for sustainable collaboration between employment agencies and Governments.Conclusion: Licensing programs appear to be effective in improving employment outcomes. Future licensing programs being delivered in regional areas need integrated pathways into employment opportunities to provide holistic services that address the social and economic challenges faced by Aboriginal and Torres Strait Islander Australians.


2018 ◽  
Author(s):  
Troy Walker ◽  
Claire Palermo ◽  
Karen Klassen

BACKGROUND Social media may have a significant role in influencing the present and future health implications among Australian Aboriginal and Torres Strait Islander people, yet there has been no review of the role of social media in improving health. OBJECTIVE This study aims to examine the extent of health initiatives using social media that aimed to improve the health of Australian Aboriginal communities. METHODS A scoping review was conducted by systematically searching databases CINAHL Plus; PubMed; Scopus; Web of Science, and Ovid MEDLINE in June 2017 using the terms and their synonyms “Aboriginal” and “Social media.” In addition, reference lists of included studies and the Indigenous HealthInfonet gray literature were searched. Key information about the social media intervention and its impacts on health were extracted and data synthesized using narrative summaries. RESULTS Five papers met inclusion criteria. All included studies were published in the past 5 years and involved urban, rural, and remote Aboriginal or Torres Strait Islander people aged 12-60 years. No studies reported objective impacts on health. Three papers found that social media provided greater space for sharing health messages in a 2-way exchange. The negative portrayal of Aboriginal people and negative health impacts of social media were described in 2 papers. CONCLUSIONS Social media may be a useful strategy to provide health messages and sharing of content among Aboriginal people, but objective impacts on health remain unknown. More research is necessary on social media as a way to connect, communicate, and improve Aboriginal health with particular emphasis on community control, self-empowerment, and decolonization.


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.


Author(s):  
Michelle Bovill ◽  
Catherine Chamberlain ◽  
Jessica Bennett ◽  
Hayley Longbottom ◽  
Shanell Bacon ◽  
...  

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.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Himanshu Gupta ◽  
Noemi Tari-Keresztes ◽  
Donna Stephens ◽  
James A. Smith ◽  
Emrhan Sultan ◽  
...  

Abstract Background Multiple culturally-oriented programs, services, and frameworks have emerged in recent decades to support the social and emotional wellbeing (SEWB) of Aboriginal and Torres Strait Islander (Aboriginal) people in Australia. Although there are some common elements, principles, and methods, few attempts have been made to integrate them into a set of guidelines for policy and practice settings. This review aims to identify key practices adopted by programs and services that align with the principles of the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017–2023. Methods A comprehensive review of electronic databases and organisational websites was conducted to retrieve studies of relevance. Twenty-seven publications were included in the review. Next, we identified promising practices through a collaborative review process. We then used the principles articulated in the above-mentioned framework as the basis to complete a framework analysis. This enabled us to explore the alignment between current scholarship about SEWB programs and services with respect to the principles of the framework. Results We found there was a strong alignment, with selected principles being effectively incorporated into most SEWB program and service delivery contexts. However, only one study incorporated all nine principles, using them as conceptual framework. Additionally, ‘capacity building’, ‘individual skill development’, and ‘development of maladaptive coping mechanisms’ were identified as common factors in SEWB program planning and delivery for Aboriginal people. Conclusion We argue the selective application of nationally agreed principles in SEWB programs and services, alongside a paucity of scholarship relating to promising practices in young people-oriented SEWB programs and services, are two areas that need the urgent attention of commissioners and service providers tasked with funding, planning, and implementing SEWB programs and services for Aboriginal people. Embedding robust participatory action research and evaluation approaches into the design of such services and programs will help to build the necessary evidence-base to achieve improved SEWB health outcomes among Aboriginal people, particularly young people with severe and complex mental health needs.


1999 ◽  
Vol 23 (6) ◽  
pp. 364-366 ◽  
Author(s):  
Jonathan Laugharne

When the Australian Governor General, Sir William Deane, referred in a speech in 1996 to the “appalling problems relating to Aboriginal health” he was not exaggerating. The Australia Bureau of Statistics report on The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples (McLennan & Madden, 1997) outlines the following statistics. The life expectancy for Aboriginal Australians is 15 to 20 years lower than for non-Aboriginal Australians, and is lower than for most countries of the world with the exception of central Africa and India. Aboriginal babies are two to three times more likely to be of lower birth weight and two to four times more likely to die at birth than non-Aboriginal babies. Hospitalisation rates are two to three times higher for Aboriginal than non-Aboriginal Australians. Death rates from infectious diseases are 15 times higher among Aboriginal Australians than non-Aboriginal Australians. Rates for heart disease, diabetes, injury and respiratory diseases are also all higher among Aboriginals – and so the list goes on. It is fair to say that Aboriginal people have higher rates for almost every type of illness for which statistics are currently recorded.


Author(s):  
Duane W. Hamacher ◽  
Kirsten Banks

Studies in Australian Indigenous astronomical knowledge reveal few accounts of the visible planets in the sky. However, what information we do have tells us that Aboriginal people are close observers of planets and their motions and properties. Indigenous Australians discerned between planets and stars by their placement in the sky and their general lack of scintillation. Traditions generally describe the ecliptic and zodiac as a pathway of sky ancestors represented by the sun, moon, and planets. This included observing the occasional backwards motion of sky ancestors as they communicate with each other during their journey across the sky, representing an explanation of retrograde motion. Aboriginal and Torres Strait Islander people note the relative brightness of the planets over time and information about the roles they play in their traditions around Australia. Knowledge systems outline the importance placed on Venus as the morning and evening star, making connections to the object as it transitions form one to the other through observations and calculation of the planet’s synodic period. Traditions note the relative positions of the planets to the moon, sun, and background stars, as well as inter planetary dust through zodiacal light, which is perceived as a celestial rope connecting Venus to the sun. The relative dearth of descriptions of planets in Aboriginal traditions may be due to the gross incompleteness of recorded astronomical traditions and of ethnographic bias and misidentification in the anthropological record. Ethnographic fieldwork with Aboriginal and Torres Strait Islander communities is revealing new, previously unrecorded knowledge about the planets and their related phenomena.


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