ORCID Profile
0000-0003-1751-1061
Current Organisation
Lowitja Institute
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Publisher: BMJ
Date: 2013
Publisher: BMJ
Date: 06-2018
Publisher: AMPCo
Date: 05-2007
DOI: 10.5694/J.1326-5377.2007.TB01019.X
Abstract: A united stand from medical professionals and organisations will send a powerful message.
Publisher: AMPCo
Date: 07-2012
DOI: 10.5694/MJA11.10858
Abstract: To determine the effectiveness of an intensive quit-smoking intervention on smoking rates at 36 weeks' gestation among pregnant Aboriginal and Torres Strait Islander women. Randomised controlled trial. Pregnant Aboriginal and Torres Strait Islander women (n = 263) attending their first antenatal visit at one of three Aboriginal community-controlled health services between June 2005 and December 2009. A general practitioner and other health care workers delivered tailored advice and support to quit smoking to women at their first antenatal visit, using evidence-based communication skills and engaging the woman's partner and other adults in supporting the quit attempts. Nicotine replacement therapy was offered after two failed attempts to quit. The control ("usual care") group received advice to quit smoking and further support and advice by the GP at scheduled antenatal visits. Self-reported smoking status (validated with a urine cotinine measurement) between 36 weeks' gestation and delivery. Participants in the intervention group (n = 148) and usual care group (n = 115) were similar in baseline characteristics, except that there were more women who had recently quit smoking in the intervention group than the control group. At 36 weeks, there was no significant difference between smoking rates in the intervention group (89%) and the usual care group (95%) (risk ratio for smoking in the intervention group relative to usual care group, 0.93 [95% CI, 0.86-1.08] P = 0.212). Smoking rates in the two groups remained similar when baseline recent quitters were excluded from the analysis. An intensive quit-smoking intervention was no more effective than usual care in assisting pregnant Aboriginal and Torres Strait Islander women to quit smoking during pregnancy. Contamination of the intervention across groups, or the nature of the intervention itself, may have contributed to this result. Australian New Zealand Clinical Trials Registry ACTRN12609000929202.
Publisher: Oxford University Press (OUP)
Date: 27-07-2017
Publisher: Frontiers Media SA
Date: 24-05-2017
Publisher: Wiley
Date: 18-05-2010
DOI: 10.1111/J.1465-3362.2009.00078.X
Abstract: A significant level of misreport or error occurs during questionnaire-based assessment of smoking behaviour. Failure to measure environmental tobacco smoke, and participant's inclination to under-report their smoking raise questions as to the accuracy of assessment. In order to establish an estimation of the possible error associated with such assessment, the accuracy of self-reported smoking status among a group of pregnant Aboriginal and Torres Strait Islander women was examined. Women attending two Aboriginal Medical services in Far North Queensland for antenatal care were invited to participate. Women completed an interviewer assisted questionnaire relating to their smoking status and a 24 h diary of their exposure to nicotine and consumption of alcohol. Urine s les were analysed for cotinine using an Enzyme Linked Immunosorbent Assay. Cotinine analysis indicated that 17% of women who reported that they were non-smokers were likely to have misreported this status, or be exposed to high levels of passive smoke. The only significant predictors of cotinine level were self-reported nicotine exposure (including passive smoke) and number of cigarettes smoked in the previous 24 h. Other in idual and environmental variables had no significant influence on cotinine level using this analysis technique. The level of potential error in smoking assessment among this group was substantial. Exposure to environmental tobacco smoke might explain part of this error, but the reasons for misreport can only be speculated. This rate of misclassification should be taken into consideration in routine screening of antenatal women in primary health care.
Publisher: AMPCo
Date: 05-2006
Publisher: AMPCo
Date: 06-2014
DOI: 10.5694/MJA14.00160
Publisher: AMPCo
Date: 03-2009
DOI: 10.5694/J.1326-5377.2009.TB02383.X
Abstract: Closing the gap in life expectancy between Indigenous and non-Indigenous Australians needs to start in the womb. Rates of perinatal mortality, preterm birth and low birthweight are two to three times greater among the babies of Indigenous women than among those of non-Indigenous women low birthweight predisposes infants to greater risks of chronic illness in later life. Indigenous women in Australia tend to present for antenatal care later in pregnancy than do non-Indigenous women. There are many barriers for Indigenous women seeking to access antenatal care - geographical, social, cultural, financial and in some cases a lack of service provision. Many of these problems are being addressed within the public health system and by Indigenous community-controlled health services. However, more needs to be done. While antenatal care cannot solve all medical and social problems, commencing such care as early as possible in pregnancy has the potential to improve maternal health and hence pregnancy outcomes. Changes in the way the government Baby Bonus is paid to new mothers could act as an incentive not only to service providers but also to women themselves to initiate antenatal care in the first trimester of pregnancy. Such a system has been well established for many years in France. Any changes to the Baby Bonus scheme should provide incentives and not be punitive in nature.
Publisher: AMPCo
Date: 03-2016
DOI: 10.5694/MJA15.00598
Abstract: To conduct an economic evaluation of intensive management by Indigenous health workers (IHWs) of Indigenous adults with poorly controlled type 2 diabetes in rural and remote north Queensland. Cost-consequence analysis alongside a cluster randomised controlled trial of an intervention delivered between 1 March 2012 and 5 September 2013. Twelve primary health care services in rural and remote north Queensland communities with predominantly Indigenous populations. Indigenous adults with poorly controlled type 2 diabetes (HbA1c ≥ 69 mmol/mol) and at least one comorbidity (87 people in six IHW-supported communities (IHW-S) 106 in six usual care (UC) communities). Per person cost of the intervention differential changes in mean HbA1c levels, percentage with extremely poor HbA1c level control, quality of life, disease progression, and number of hospitalisations. The mean cost of the 18-month intervention trial was $10 060 per person ($6706 per year). The intervention was associated with a non-significantly greater reduction in mean HbA1c levels in the IHW-S group (-10.1 mmol/mol v -5.4 mmol/mol in the UC group P = 0.17), a significant reduction in the proportion with extremely poor diabetes control (HbA1c ≥ 102 mmol/mol P = 0.002), and a sub-significant differential reduction in hospitalisation rates for type 2 diabetes as primary diagnosis (-0.09 admissions erson/year P = 0.06), with a net reduction in mean annual hospital costs of $646 erson (P = 0.07). Quality of life utility scores declined in both groups (between-group difference, P = 0.62). Rates of disease progression were high in both groups (between-group difference, P = 0.73). Relative to the high cost of the intervention, the IHW-S model as implemented is probably a poor investment. Incremental cost-effectiveness might be improved by a higher caseload per IHW, a longer evaluation time frame, and improved service integration. Further approaches to improving chronic disease outcomes in this very unwell population need to be explored, including holistic approaches that address the complex psychosocial, pathophysiological and environmental problems of highly disadvantaged populations. ANZCTR12610000812099.
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/PY09032
Abstract: Indigenous men’s support groups are designed to empower men to take greater control and responsibility for their health and wellbeing. They provide health education sessions, counselling, men’s health clinics, ersionary programs for men facing criminal charges, cultural activities, drug- and alcohol-free social events, and advocacy for resources. Despite there being ~100 such groups across Australia, there is a dearth of literature on their strategies and outcomes. This paper is based on participatory action research involving two north Queensland groups which were the subject of a series of five ‘phased’ evaluative reports between 2002 and 2007. By applying ‘meta-ethnography’ to the five studies, we identified four themes which provide new interpretations of the data. Self-reported benefits included improved social and emotional wellbeing, modest lifestyle modifications and willingness to change current notions of ‘gendered’ roles within the home, such as sharing housework. Our qualitative research to date suggests that through promoting empowerment, wellbeing and social cohesion for men and their families, men’s support groups may be saving costs through reduced expenditure on health care, welfare, and criminal justice costs, and higher earnings. Future research needs to demonstrate this empirically.
Publisher: Wiley
Date: 07-2014
DOI: 10.5694/MJAC13.00005
Publisher: AMPCo
Date: 02-2008
Publisher: AMPCo
Date: 05-2006
Publisher: Springer Science and Business Media LLC
Date: 12-2016
Publisher: AMPCo
Date: 10-2006
Publisher: Informa UK Limited
Date: 03-03-2020
Publisher: Frontiers Media SA
Date: 07-03-2017
Publisher: AMPCo
Date: 06-2014
DOI: 10.5694/MJA13.00005
Abstract: The national Closing the Gap framework commits to reducing persisting disadvantage in the health of Aboriginal and Torres Strait Islander people in Australia, with cross-government-sector initiatives and investment. Central to efforts to build healthier communities is the Aboriginal community controlled health service (ACCHS) sector its focus on prevention, early intervention and comprehensive care has reduced barriers to access and unintentional racism, progressively improving in idual health outcomes for Aboriginal people. There is now a broad range of primary health care data that provides a sound evidence base for comparing the health outcomes for Indigenous people in ACCHSs with the outcomes achieved through mainstream services, and these data show: models of comprehensive primary health care consistent with the patient-centred medical home model coverage of the Aboriginal population higher than 60% outside major metropolitan centres consistently improving performance in key performance on best-practice care indicators and superior performance to mainstream general practice. ACCHSs play a significant role in training the medical workforce and employing Aboriginal people. ACCHSs have risen to the challenge of delivering best-practice care and there is a case for expanding ACCHSs into new areas. To achieve the best returns, the current mainstream Closing the Gap investment should be shifted to the community controlled health sector.
Publisher: Frontiers Media SA
Date: 19-07-2019
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/PY12033
Abstract: This article evaluates the pilot phase of an Aboriginal and Torres Strait Islander Male Health Module. Although men experience higher levels of illness and die younger than women, educational programs to support health workers utilise a gender-based approach to increase participation of Aboriginal and Torres Strait Islander males in health care are rare and lack appropriate content. Recognising this gap in service provision, and under the guidance of a Reference Group comprising community leaders in Aboriginal and Torres Strait male health, a comprehensive and culturally appropriate Male Health Module has been developed to enhance the capacity of health workers to improve access to services for Aboriginal and Torres Strait Islander males. Methods used were: in-depth interviews with Module developers, pilot workshops for trainers and health workers, questionnaires and focus group discussions with workshop participants, and participant observations. As well as enhancing capacity to facilitate access to health services for men, the Module was deemed relevant because of its potential to promote health worker empowerment and wellbeing. Findings revealed that improving access to services for men required male and female health workers working in partnership. Despite overall enthusiasm for the Module, the findings also revealed deep fear that it would end up ‘collecting dust on shelves’. Strategies to improve the Module quality and accessibility are highlighted.
Publisher: Cambridge University Press (CUP)
Date: 24-10-2008
DOI: 10.1017/S0950268807009740
Abstract: Skin infections are highly prevalent in many Australian Aboriginal communities. This study aimed to determine the prevalence of group A streptococcus (GAS) and Staphylococcus aureus in skin sores of Indigenous people living in an urban setting. We undertook a cross-sectional study of 173 children and youths attending the Wuchopperen Clinic (Cairns) for treatment of skin infections. Participants were interviewed using a structured questionnaire, and a skin lesion swab obtained. The median age was 5·3 years, with 42% identifying themselves as Torres Strait Islanders and 34% as Aboriginal. Impetigo (65%) was the most frequent diagnosis reported followed by scabies (19%) 79% of the lesions had erythema and 70% had exudate. Of 118 lesions, 114 were positive for pathogenic bacteria, with GAS isolated in 84 cases and S. aureus in 92 both these species were recovered from 63 lesions. Significant ersity of emm -types of GAS was associated with skin lesions in Indigenous patients (22 emm -types identified). Fifteen of the 92 S. aureus isolates were suggestive of being community-acquired on the basis of antimicrobial susceptibility profile and nine of these strains were co-cultured from nine lesions. These results have implications for future changes of antibiotic policies for the treatment of skin infections in this population.
Publisher: AMPCo
Date: 05-2009
DOI: 10.5694/J.1326-5377.2009.TB02562.X
Abstract: To identify factors associated with antenatal smoking and explore characteristics of smoking behaviour among pregnant Aboriginal and Torres Strait Islander women. Cross-sectional study using interviewer-administered questionnaires of 145 pregnant Aboriginal and Torres Strait Islander women attending a health service in Far North Queensland between November 2005 and December 2006. Prevalence of self-reported smoking predictors and patterns of smoking in early pregnancy and relationships between smoking and the prevalence of predisposing, enabling and reinforcing factors, including women's knowledge about and attitudes towards smoking and the risks involved. Of 145 women, 41% (n = 60) reported being daily or occasional smokers. Knowledge about harms of smoking was generally high. Women who were smokers had a significantly higher rate of smoking partners (n = 36) than women who were non-smokers (n = 31) (77% v 41%, P < 0.001). Level of daily stress was significantly higher among smokers than non-smokers (P = 0.001). Shifted population norms among Aboriginal and Torres Strait Islanders are accompanied by a shift in the factors that can effectively differentiate between smokers and non-smokers within this population. Rather than the traditional, mainstream predictors of antenatal smoking, interventions with Aboriginal and Torres Strait Islander women should focus on the social environment, and the influences of social networks and partners on the behaviour of in iduals.
Publisher: Elsevier BV
Date: 12-2008
Publisher: AMPCo
Date: 05-2009
Publisher: Frontiers Media SA
Date: 23-10-2018
Publisher: CSIRO Publishing
Date: 2004
DOI: 10.1071/PY04057
Abstract: Since 2001 a team of academic researchers and medical practitioners have been collaborating with Yarrabah Men?s Health Group leaders to implement a participatory action research (PAR) process designed to support the men to (in their own words) ?take their rightful place? in contemporary Australian society. The formative stages of the PAR process and progress over the first 12 months have been documented in previous papers in order to provide much needed direction for others interested in undertaking similar community action-oriented research (Tsey, Patterson, Whiteside, Baird, & Baird, 2002 Tsey et al., 2004). The present paper addresses the need for innovative evaluation methodologies to enable participants in the PAR process to monitor and reinforce the small improvement they are making towards achieving their goals, and to maintain their vision for the future. Participation in men?s group activities resulted in modest but significant change in the men?s personal development and growth and in their response to family responsibilities. Men had the opportunity to dialogue and reflect on their gender responsibilities such as housework, which constitutes a major source of conflict in the family. Several men also gained the confidence and motivation to stand for local government. The study highlights the value of demystifying and making research more relevant to people?s day-to-day living experiences.
Publisher: AMPCo
Date: 08-2007
Publisher: SAGE Publications
Date: 02-2007
DOI: 10.1080/10398560701701163
Abstract: Objectives: This paper describes a research program that has operationalized the links between empowerment at personal/family, group/organizational and community/structural levels and successful mechanisms to address Indigenous social and emotional wellbeing issues such as family violence and abuse, suicide prevention and incarceration. Methods: A two-pronged approach, involving the Family Wellbeing Empowerment Program and Participatory Action Research, was used to enhance the capacity of program participants and their communities to take greater charge of issues affecting their health and wellbeing. Results: Key program outcomes include an enhancement of participants’ sense of self worth, resilience, problem-solving ability, ability to address immediate family difficulties as well as belief in the mutability of the social environment. There is also evidence of increasing capacity to address wider structural issues such as poor school attendance rates, the critical housing shortage, endemic family violence, alcohol and drug misuse, chronic disease, and over-representation of Indigenous men in the criminal justice system. Participants are also breaking new ground in areas such as values-based Indigenous workforce development and organizational change, as well as issues about contemporary Indigenous spirituality. Conclusions: The use of a long-term (10-year) community research strategy focussing directly on empowerment has demonstrated the power of this approach to facilitate Indigenous people's capacity to regain social and emotional wellbeing and begin to rebuild the social norms of their families and community.
Start Date: 2010
End Date: 2016
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2014
End Date: 2019
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2018
End Date: 2006
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2004
End Date: 2006
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2013
End Date: 2018
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2004
End Date: 2005
Funder: Canadian Institutes of Health Research
View Funded ActivityStart Date: 2017
End Date: 2019
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2010
End Date: 2017
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2008
End Date: 2009
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2005
End Date: 2007
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2005
End Date: 2009
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2016
End Date: 2019
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2017
End Date: 2021
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2015
End Date: 2019
Funder: National Health and Medical Research Council
View Funded Activity