ORCID Profile
0000-0002-0651-899X
Current Organisations
University of Western Australia
,
Edith Cowan University
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Aboriginal and Torres Strait Islander Languages | Public Health and Health Services | Performing Arts and Creative Writing | Landscape Ecology | Community Child Health | Sociological Methodology and Research Methods | Aboriginal and Torres Strait Islander Health | Aboriginal and Torres Strait Islander Performing Arts
Environmental Education and Awareness | Dental Health | Child Health | Conserving Aboriginal and Torres Strait Islander Heritage | Music | Health Inequalities |
Publisher: Wiley
Date: 12-12-2006
DOI: 10.1111/J.1445-5994.2006.01247.X
Abstract: We analysed data from Aboriginal patients with type 2 diabetes recruited to the community-based Fremantle Diabetes Study and compared them with those from the Anglo-Celt participants. Diabetes prevalence among Aboriginal people in the Fremantle area was more than double that of Anglo-Celts and the average age at diagnosis was 14 years or younger. Glycaemic control, urinary albumin :creatinine and the proportion of smokers were all higher in the Aboriginal group and there was evidence of lower diabetes-related quality of life and high rates of disability at a young age. The Aboriginal patients died 18 years or younger than their Anglo-Celt counterparts. Specialized, culturally-sensitive and sustainable programmes are urgently needed to improve the management of diabetes in urban Aboriginal communities.
Publisher: Springer Science and Business Media LLC
Date: 12-01-2016
Publisher: Elsevier BV
Date: 09-2006
Publisher: BMJ
Date: 03-12-2010
Abstract: Antismoking mass media c aigns have been shown to reduce smoking prevalence in the mainstream community, however there is little published research on their effect on Aboriginal Australian smokers. To evaluate the awareness and impact of a mainstream mass media advertising c aign (the 'Bubblewrap' c aign) on Aboriginal smokers in the state of Western Australia. A personal intercept survey was conducted in July 2008 across three sites (the Perth metropolitan area and the non-metropolitan towns of Kalgoorlie and Broome). An opportunity or convenience s ling strategy was used to recruit Aboriginal participants, and face-to-face interviews were conducted with 198 Aboriginal smokers to ascertain awareness of the c aign advertisements, whether they were seen as believable and relevant, and the impact the advertisements had on smoking behaviour. The majority of the participants interviewed had seen and/or heard the 'Bubblewrap' c aign advertisements, although there was considerably greater awareness of the television advertisement than the radio advertisements. Both forms of advertising were considered to be believable and relevant by the majority of Aboriginal smokers. Most of the smokers interviewed thought about cutting down and/or quitting after seeing or hearing the advertisements. Our findings suggest that mainstream antismoking mass media c aigns can positively influence the thoughts and behaviours that Aboriginal smokers have, and exhibit, towards quitting smoking. Notwithstanding this, advertisers should continue to look for better ways to incorporate Aboriginal themes in c aign messages. Future mainstream antismoking c aigns should source sufficient funds to ensure that advertising messages reach the large Aboriginal populations in regional and remote Australia.
Publisher: Elsevier BV
Date: 02-2004
DOI: 10.1111/J.1467-842X.2004.TB00631.X
Abstract: Diabetes is a major health problem for the Aboriginal population of Australia. Early detection is a key strategy to reduce the burden of diabetes. The aim of this study was to assess the acceptability, sensitivity and specificity, effectiveness and cost of a new method of screening for diabetes at Derbarl Yerrigan, the Aboriginal health service in Perth. Between January and May 1999, all clients over the age of 30 years and not known to have diabetes were approached for HbA1c testing using the DCA 2000 analyser. Those whose HbA1c results indicated the need for follow-up were asked to return for confirmatory testing using the gold standard oral glucose tolerance test (OGTT). A questionnaire was administered to participants who did not return. A file audit was conducted over 15 non-consecutive days to determine screening, follow-up and the number of new cases diagnosed using the previous ad hoc approach to screening with a glucometer. 238 clients were approached and all agreed to participate and undertook the test. Of these, 37 were referred for follow-up diagnostic testing. Of these, only 14 had an OGTT. Among these 14, five were found to have diabetes and three were found to have impaired glucose tolerance. Of the remaining 23 participants, we were able to contact only six and administer the questionnaire to four. Poor follow-up meant that the sensitivity, specificity and cost-effectiveness of the test could not be assessed. The reasons for poor follow-up need to be investigated if Aboriginal health services are to be more successful at screening for diabetes.
Publisher: BMJ
Date: 23-08-2003
Publisher: Springer Science and Business Media LLC
Date: 05-01-2023
DOI: 10.1186/S12884-022-05136-6
Abstract: Evidence suggests that Aboriginal babies in Western Australia are not receiving adequate primary health care in their first 3 months of life, leading to questions about enablers and constraints to delivering such care. This paper presents findings from a qualitative research project investigating health providers’ perceptions and experiences of best and current practice in discharge planning, postnatal care and health education for Aboriginal mothers and their newborn babies. Constructivist grounded theory guided this research involving 58 semi-structured interviews conducted with health providers who deliver care to Aboriginal mothers and infants. Participants were recruited from hospital-based and primary health sites in metropolitan Perth, and regional and remote locations in Western Australia. Structural factors enabling best practice in discharge planning, postnatal care, and health education for mothers included health providers following best practice guidelines and adequate staffing levels. Organisational enablers included continuity of care throughout pregnancy, birth and postnatally. In particular, good communication between services around discharge planning, birth notifications, and training in culturally respectful care. Structural and organisational constraints to delivering best practice and compromising continuity of care were identified as beyond in idual control. These included poor communication between different health and social services, insufficient hospital staffing levels leading to early discharge, inadequate cultural training, delayed receipt of birth notifications and discharge summaries received by Aboriginal primary health services. Findings highlight the importance of examining current policies and practices to promote best practice in postnatal care to improve health outcomes for mothers and their Aboriginal babies.
Publisher: Wiley
Date: 13-02-2023
DOI: 10.1111/AJAG.13174
Abstract: To investigate how small, local organisations were impacted by and responded to COVID‐19 in their delivery of social care services to older adults (70 years and older). Lessons learnt and future implications are discussed. Six representatives from four social care services (five females and one male) participated in in idual semistructured interviews. Responses were analysed thematically. The key themes identified were service providers' experience, perceived needs of older adults and adapting services. Service providers positioned themselves as front‐line essential workers for their older adult clients, resulting in some emotional toll and distress for the service providers. They provided information, wellness checks and at‐home assistance to keep their older adult clients connected. Service providers feel more prepared for future restrictions but flag the potential of training and supporting older adults to use technology to stay connected, as well as the need for more readily available funding to allow services to adapt quickly during times of crisis.
Publisher: Swansea University
Date: 05-09-2018
Abstract: IntroductionThe IDEA system is a population-based data linkage system for intellectual disability (ID), which combines data from two government departments. Due to recent policy changes the future of the IDEA system is unknown. Understanding the IDEA system's strengths and limitations will provide data custodians with the opportunity to re-design the system. Objectives and ApproachAn evaluation of the IDEA surveillance system was undertaken to assess the quality, efficiency and usefulness of the system. The primary objectives were to evaluate systematically and objectively the attributes of the system and provide recommendations to data custodians and stakeholders to strengthen the surveillance system. The evaluation was based on the methods from the 2001 U.S. Centers for Disease Control and Prevention guidelines on evaluation of public health surveillance systems. We assessed the following system attributes: usefulness, simplicity, flexibility, data quality, acceptability, representativeness, timeliness, and stability. This was completed by process observation, semi-structured interviews and data analysis. ResultsOur results found the IDEA system was flexible, acceptable, representative, timely and stable. Given data linkage process and maintaining confidentiality the data linkage process was considered relatively simple. We compared in iduals in the IDEA surveillance system to a sub-group of in iduals, cerebral palsy with ID, to the mandatory reporting surveillance system WARDA-CP. There were 582 in iduals identified in the WARDA-CP surveillance system as having cerebral palsy and ID. Of those identified 501 (86.1%) were also in the IDEA database and 81 (13.9%) were not. There were little differences in WARDA-CP cases that were not identified in the IDEA system between Indigenous status, sex and place of residence. Conclusion/ImplicationsThe IDEA system has successfully been used to understand prevalence rates and inform resource allocation. Advocacy organisations could play an important role in the sustainability of the system. Additional variables or enhanced surveillance for functional capacity could strengthen the system and provide important information to inform policy and practice.
Publisher: Wiley
Date: 22-08-2017
DOI: 10.1111/JPC.13673
Abstract: To determine whether participation in the continuous quality improvement (CQI) Audit and Best Practice for Chronic Disease programme improved care and outcomes for Indigenous children. Data were collected from 59 Australian primary health-care centres providing services to Indigenous people and participating in the programme (February 2008 and December 2013). Indigenous children aged less than 2 years and centres that completed three or more consecutive annual audits within the 6-year study period were included. Crude and adjusted logistic generalised estimating equation models were used to examine the effect of year of audit on the delivery of care. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Outcomes were related to age-relevant health issues, including prevention and early intervention. These included administrative, health check, anticipatory guidance and specific health issues. During the audit period, there were 2360 files from 59 centres. Those that had a recall recorded, improved from 84 to 95% (OR 2.44, 95% CI 1.44-4.11). Hearing assessments improved from 52 to 89% (OR 1.37, 95% CI 1.22-1.54). Improvement in anticipatory guidance, treatment and follow-up of medical conditions was almost universal. We documented significant improvements in quality of care of Indigenous children. Outcomes and their corresponding treatment and follow-ups improved over time. This appears to be related to services participating in annual CQI activities. However, these services may be more committed to CQI than others and therefore possibly better performing.
Publisher: Public Library of Science (PLoS)
Date: 27-04-2016
Publisher: Swansea University
Date: 16-03-2020
Abstract: 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.
Publisher: Springer Science and Business Media LLC
Date: 12-2012
Abstract: Streptococcus pneumoniae (Pnc), nontypeable Haemophilus influenzae (NTHi) and Moraxella catarrhalis (Mcat) are the most important bacterial pathogens associated with otitis media (OM). Previous studies have suggested that early upper respiratory tract (URT) bacterial carriage may increase risk of subsequent OM. We investigated associations between early onset of URT bacterial carriage and subsequent diagnosis of OM in Aboriginal and non-Aboriginal children living in the Kalgoorlie-Boulder region located in a semi-arid zone of Western Australia. Aboriginal and non-Aboriginal children who had nasopharyngeal aspirates collected at age 1- 3 months and at least one clinical examination for OM by an ear, nose and throat specialist before age 2 years were included in this analysis. Tympanometry to detect middle ear effusion was also performed at 2- to 6-monthly scheduled field visits from age 3 months. Multivariate regression models were used to investigate the relationship between early carriage and subsequent diagnosis of OM controlling for environmental factors. Carriage rates of Pnc, NTHi and Mcat at age 1- 3 months were 45%, 29% and 48%, respectively, in 66 Aboriginal children and 14%, 5% and 18% in 146 non-Aboriginal children. OM was diagnosed at least once in 71% of Aboriginal children and 43% of non-Aboriginal children. After controlling for age, sex, presence of other bacteria and environmental factors, early nasopharyngeal carriage of NTHi increased the risk of subsequent OM (odds ratio = 3.70, 95% CI 1.22-11.23) in Aboriginal children, while Mcat increased the risk of OM in non-Aboriginal children (odds ratio = 2.63, 95% CI 1.32-5.23). Early carriage of Pnc was not associated with increased risk of OM. Early NTHi carriage in Aboriginal children and Mcat in non-Aboriginal children is associated with increased risk of OM independent of environmental factors. In addition to addressing environmental risk factors for carriage such as overcrowding and exposure to environmental tobacco smoke, early administration of pneumococcal- Haemophilus influenzae D protein conjugate vaccine to reduce bacterial carriage in infants, may be beneficial for Aboriginal children such an approach is currently being evaluated in Australia.
Publisher: Wiley
Date: 07-2006
DOI: 10.1111/J.1440-1754.2006.00895.X
Abstract: Aim: To analyse patterns and trends in mortality from unknown causes (sudden infant death syndrome and unascertainable deaths) for all Aboriginal and non‐Aboriginal infants born in Western Australia, 1980–2001. Methods: Using total population linked data, we reviewed all post‐mortem reports, including death scene investigations and final causes of death as ascertained by the coroner. Neonatal, post‐neonatal and infant mortality rates attributed to unknown causes were calculated and the latter were analysed according to maternal age, geographical location, gestational age, sex and birthweight. Relative risks (95% confidence interval) for Aboriginal infants (compared with non‐Aboriginal) were calculated. Results: The proportion of deaths considered to be of unascertainable cause has significantly increased in recent years. In contrast to the non‐Aboriginal population, there has been no significant decrease in deaths in the Aboriginal population and the overall relative risk for Aboriginal infants for the most recent years studied was 7.9 (95% confidence interval 5.1–12.2). The relative risk was significantly increased for most categories analysed. Conclusion: Reviewing post‐mortem reports enabled identification of changes in the classification of deaths due to unknown causes. This provided a more accurate picture of the patterns and long‐term trends of such deaths so that programmes can be developed to specifically target those groups most at risk. Adequately funded and evaluated education c aigns aimed at reducing the risk of sudden infant death syndrome among Aboriginal infants are required, as well as sustaining the current efforts that have been so successful for non‐Aboriginal infants.
Publisher: AMPCo
Date: 03-2016
DOI: 10.5694/MJA15.00827
Abstract: To determine whether the Koorliny Moort program could reduce emergency department presentations, hospital admissions and length of stay, and improve attendance at out-of-hospital appointments for Aboriginal and Torres Strait Islander children in Western Australia. Children were enrolled in the program from 1 August 2012. Each child acted as their own control. Evaluation data were collected from 1 August 2010 to 31 July 2014. Occasions of service and person-time in days were compared for each child before and after referral to the program. Aboriginal children aged 0-16 years residing in three WA regions (Kimberley, Pilbara, Perth metropolitan) who were referred to the Koorliny Moort program. Partnerships with primary care providers nurse-led care coordination and outreach care by paediatricians, nurses and social workers closer to the home of the child. Emergency department presentations hospital admissions length of hospital stay non-attended appointments. A total of 942 children were referred to the program. There were significant decreases after referral to the program in the incidence of emergency department presentations (incident rate ratio [IRR], 0.47 95% CI, 0.43-0.53 P < 0.001), of hospitalisation (IRR, 0.70 95% CI, 0.62-0.79 P < 0.001), and of non-attended appointments (IRR, 0.83 95% CI, 0.74-0.94 P < 0.001), as well as in the mean length of hospital stay (IRR, 0.23 95% CI, 0.21-0.25 P < 0.001). Health-seeking behaviour and health outcomes for Aboriginal children can be improved by engaging Aboriginal families in their health care, providing effective communication between health service providers, and delivering a coordinated program of Aboriginal service provider-led care.
Publisher: Elsevier BV
Date: 05-2006
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.DIABRES.2014.12.014
Abstract: To determine the prevalence and associates of depression in Aboriginal and Anglo-Celt (AC) Australians with type 2 diabetes. Community-based patients were screened using the Patient Health Questionnaire (PHQ-9) as part of detailed assessment. The prevalence of any current depression, major depression and antidepressant use by racial group was compared after adjustment for age, sex, educational attainment and marital status. Multiple logistic regression was used to determine associates of current depression. The 107 Aboriginal participants were younger (mean±SD 54.3±11.8 vs. 67.2±10.6 years), less often male (34.6% vs. 50.9%) and married (39.3% vs. 61.7%), and more likely to smoke (44.6% vs. 8.1%) than the 793 AC subjects (P≤0.002). Fifty-two Aboriginal (48.5%) and 772 AC participants (97.4%) completed the PHQ-9 these Aboriginals had similar socio-demographic, anthropometric and diabetes-related characteristics to those without PHQ-9 data. A quarter of the Aboriginals had current depression vs 10.6% of ACs (P=0.16), 15.4% vs. 4.1% had major depression (P=0.029), and 68.8% vs. 29.7% had untreated depression (P=0.032). Compared with non-depressed participants, patients with current depression were younger and more likely to smoke, to be overweight/obese and to have worse glycaemic control (P≤0.024). Significant independent associates of current depression were educational attainment (inversely), smoking status, body mass index and fasting plasma glucose in the AC group and alcohol use in the Aboriginal group. Although prevalence of depression was not significantly increased in the Aboriginal patients, it was more likely to be major and untreated. Depression complicating type 2 diabetes is associated with adverse cardiovascular risk.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2010
Publisher: MDPI AG
Date: 02-09-2020
Abstract: Cultural security is a key element of accessible services for Indigenous peoples globally, although few studies have examined this empirically. We explored the scope, reach, quality, and cultural security of health and social services available to Aboriginal and/or Torres Strait Islander families in Western Australia (WA), from the point of view of staff from the services. We recruited staff from health and social services for Aboriginal people in the Perth, Kalgoorlie, Great Southern, and South West regions of WA between December 2015 and September 2017 to complete online surveys. We examined the proportions of participants that responded saying the service was culturally secure, the reasons for the response, and perceived factors related to a high-quality service. Sixty participants from 21 services responded to the survey. Seventy-three percent stated the service was culturally secure however, only 36% stated that the staff employed at the service had sufficient knowledge on cultural security. Participants suggested having Aboriginal staff and better cultural awareness training as methods to improve cultural security within the service. Participants highlighted that staffing, funding for resources, and patient financial difficulties in accessing care as key areas for quality improvement. Much greater effort is required in improving knowledge through on-going training of staff in the practice of culturally safe care. Organisations must also be required to meet specific standards in cultural safety.
Publisher: Wiley
Date: 19-12-2007
Publisher: BMJ
Date: 10-2019
DOI: 10.1136/BMJOPEN-2018-026003
Abstract: Our overall aim was to evaluate the Western Australian Intellectual Disability Exploring Answers (IDEA) surveillance system. The primary objective was to evaluate the attributes of the system. The secondary objective was to provide recommendations to data custodians and stakeholders to strengthen the system. The IDEA system was evaluated using process observation, interviews and secondary data analysis of system attributes: usefulness, simplicity, data quality, acceptability, representativeness, timeliness and stability. 2001 US Centers for Disease Control and Prevention guidelines were used. We found that the IDEA system was useful, simple, flexible, acceptable, representative, timely and stable. We compared in iduals from the IDEA system (n=10 593) with those with cerebral palsy and intellectual disability (ID) (n=582) from another surveillance system. Of the 582 with cerebral palsy and ID, 501 (86.1%) were in the IDEA system and 81 (13.9%) were not. In total, 0.7% of cases (81/10674) with ID were not identified in the IDEA system. There were little differences in cases that were not identified in the IDEA system between Indigenous status, sex and place of residence. The strengths of the IDEA system include having a high data quality resource contributing to national and international data on ID, strong government support and a dedicated management team. Output from studies linking to IDEA data have had major contributions to the international literature about ID. However, limited resources have prevented it from realising its full potential in relation to translational activities. The IDEA system is a valuable resource to address the needs of people living with ID.
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/HC18006
Abstract: ABSTRACT INTRODUCTION Primary health care organisations need to continuously reform to more effectively address current health challenges, particularly for vulnerable populations. There is growing evidence that optimal health service structures are essential for producing positive outcomes. AIM To determine if there is an association between process of care indicators (PoCIs) for important young indigenous child health and social issues and: (i) primary health-care service and child characteristics and (ii) organisational health service structures. METHODS This was a cross-sectional study of 1554 clinical child health audits and associated system assessments from 74 primary care services from 2012 to 2014. Composite PoCIs were developed for social and emotional wellbeing, child neurodevelopment and anaemia. Crude and adjusted logistic regression models were fitted, clustering for health services. Odds ratios and 95% confidence intervals were derived. RESULTS Overall, 32.0% (449) of records had a social and emotional wellbeing PoCI, 56.6% (791) had an anaemia PoCI and 49.3% (430) had a child neurodevelopment PoCI. Children aged 12–23 months were significantly more likely to receive all PoCIs compared to children aged 24–59 months. For every one point increase in assessment scores for team structure and function (aOR 1.14, 95% CI 1.01–1.27) and care planning (aOR 1.14, 95% CI 1.01–1.29) items, there was a 14% greater odds of a child having an anaemia PoCI. Social and emotional wellbeing and child neurodevelopment PoCIs were not associated with system assessment scores. DISCUSSION Ensuring young indigenous children aged 24–59 months are receiving quality care for important social and health indicators is a priority. Processes of care and organisational systems in primary care services are important for the optimal management of anaemia in indigenous children.
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/PY15139
Abstract: A rapidly expanding interest in quality in the Aboriginal-community-controlled health sector has led to widespread uptake of accreditation using more than one set of standards, a proliferation of continuous quality improvement programs and the introduction of key performance indicators. As yet, there has been no overarching logic that shows how they relate to each other, with consequent confusion within and outside the sector. We map the three approaches to the Framework for Performance Assessment in Primary Health Care, demonstrating their key differences and complementarity. There needs to be greater attention in both policy and practice to the purposes and alignment of the three approaches if they are to embed a system-wide focus that supports quality improvement at the service level.
Publisher: BMJ
Date: 07-08-2018
DOI: 10.1136/ARCHDISCHILD-2018-315164
Abstract: Our primary objective was to assess if sustained participation in continuous quality improvement (CQI) activities could improve delivery of ‘basic developmental care’ to disadvantaged children in primary care settings. Secondary objectives were to assess if delivery of developmental care differed by age and geographic location.Data were analysed using multivariable logistic regression and generalised estimating equations. 109 indigenous primary care centres across Australia from 2012 to 2014 and2466 client files from indigenous children aged 3–59 months were included. Outcome measures were delivery of basic developmental care.We found that the proportion of children who received basic developmental care ranged from 55% (advice about physical and mental stimulation of child) (1279, 55.1%) to 74% (assessment of developmental milestones) (1510, 73.7%). Ninety-three per cent (92.6%, 88) of children received follow-up care. Centres with sustained CQI participation (completed three or more consecutive audit cycles) (508, 53.9%) were twofold more likely to deliver basic developmental care compared with centres without sustained CQI (completed less than three consecutive audit cycles) (118, 31.0%) (adjusted OR (aOR) 2.37, 95% CI 1.33 to 4.23). Children aged 3–11 months (229, 54.9%) were more likely to receive basic developmental care than children aged 24–59 months (151, 38.5%) (aOR 2.42, 95% CI 1.67 to 3.51). Geographic location had little effect (aOR 0.68, 95% CI 0.30 to 1.53). Overall our study found that sustained CQI can improve basic developmental care in primary care settings. However, many disadvantaged children are not receiving services. Improved resourcing of developmental care and CQI in primary care centres is needed.
Publisher: SAGE Publications
Date: 27-09-2016
Abstract: Despite dedicated government funding, Aboriginal Australians, including children, experience more dental disease than other Australians, despite it being seen as mostly preventable. The ongoing legacy of colonization and discrimination against Aboriginal Australians persists, even in health services. Current neoliberal discourse often holds in iduals responsible for the state of their health, rather than the structural factors beyond in idual control. While presenting a balanced view of Aboriginal health is important and attests to Indigenous peoples’ resilience when faced with persistent adversity, calling to account those structural factors affecting the ability of Aboriginal people to make favorable oral health choices is also important. A decolonizing approach informed by Indigenous methodologies and whiteness studies guides this article to explore the perceptions and experiences of Aboriginal parents ( N = 52) of young children, mainly mothers, in Perth, Western Australia, as they relate to the oral health. Two researchers, 1 Aboriginal and 1 non-Aboriginal, conducted 9 focus group discussions with 51 Aboriginal participants, as well as 1 interview with the remaining in idual, and independently analyzed responses to identify themes underpinning barriers and enablers to oral health. These were compared, discussed, and revised under key themes and interpreted for meanings attributed to participants’ perspectives. Findings indicated that oral health is important yet often compromised by structural factors, including policy and organizational practices that adversely preclude participants from making optimal oral health choices: limited education about prevention, prohibitive cost of services, intensive marketing of sugary products, and discrimination from health providers resulting in reluctance to attend services. Current government intentions center on Aboriginal–non-Aboriginal partnerships, access to flexible services, and health care that is free of racism and proactively seeks and welcomes Aboriginal people. The challenge is whether these good intentions are matched by policies and practices that translate into sustained improvements to oral health for Aboriginal Australians. Knowledge Transfer Statement: Slow progress in reducing persistent oral health disparities between Aboriginal and non-Aboriginal Australians calls for a new approach to this seemingly intractable problem. Findings from our qualitative research identified that structural factors—such as cost of services, little or no education on preventing oral disease, and discrimination by health providers—compromised Aboriginal people’s optimum oral health choices and access to services. The results from this study can be used to recommend changes to policies and practices that promote rather than undermine Aboriginal health and well-being and involve Aboriginal people in decisions about their health care.
Publisher: Springer Science and Business Media LLC
Date: 11-07-2018
Publisher: Elsevier BV
Date: 04-2020
Publisher: Wiley
Date: 06-2008
DOI: 10.1111/J.1440-1754.2008.01306.X
Abstract: To explore the causal pathways leading to poor birth outcomes among a cohort of Aboriginal infants. A cross-sectional study was conducted. Data were collected via face-to-face interviews conducted 6-12 weeks post partum and links to the WA Midwives' Notification System. Two hundred and seventy-three Aboriginal infants and their families from Perth, Western Australia were recruited in the mid to late 1990s. Poor birth outcome was defined as low birth weight and/or preterm birth. Criteria for poor birth outcome were met by 12.3% of the cohort. A history of maternal hypertension, vaginal bleeding and consumption of excess spirits in pregnancy were independent predictors of poor birth outcome. Mother being raised on a mission, maternal education, smoking during pregnancy and being exposed to passive smoke during pregnancy were also important risk factors. Results indicate that maternal social exposures, maternal ill-health before the index pregnancy and maternal ill-health during the index pregnancy are all important contributors to poor birth outcomes for urban Aboriginal infants. While the causes of poor birth outcomes are complex, the current study highlights several areas where preventive measures may be useful.
Publisher: Wiley
Date: 12-2014
Publisher: Wiley
Date: 30-09-2021
DOI: 10.1111/JPC.15701
Abstract: Until the recent death in Dubbo of an Aboriginal man, there have been no deaths from Covid 19 in Australia. The extraordinary success of Aboriginal and Torres Strait Islander populations in controlling the effects of this pandemic has been a global role model. Until early 2021, in spite of their high risk status, dispersed population and fear of health services due to racism, Indigenous outcomes were better than those for non‐Indigenous. Aboriginal health leaders at every level brought in worlds best practices and applied them in all urban, rural and remote locations. Instead of the many hundreds of cases, hospitalisation and deaths expected, there were only 150 cases nationwide with15% hospitalised but no one in ICU and no deaths. This result is a complete reversal of the gap and was due to the outstanding Indigenous leadership, that governments at all levels listened to Aboriginal wisdom and that control was handed to those who knew what to do. This result is not only evidence for why a Voice enshrined in the Constitution would work, it heralds a new way of working with Aboriginal people in Australia. This viewpoint makes the case for a different model to engage and empower First Nations to really close the gap ‐ themselves.
Publisher: Journal of Privacy and Confidentiality
Date: 20-07-2012
Abstract: A remote analysis system addresses the challenge of enabling the use of confidential or private data while maintaining standards of confidentiality and privacy. Traditional approaches typically involve reducing the risk of disclosure by modifying or confidentialising data before releasing it to users. In contrast, a remote analysis system enables users to submit statistical queries and receive output without direct access to the data. A remote analysis system may involve confidentialisation of the underlying data itself or the system outputs, or both. In this paper we discuss the implementation of a remote analysis system enabling survival analysis. In this system the underlying data are not confidentialised, although for some analyses a random s le of the data is used, and the system outputs are modified to protect confidentiality and privacy. We describe confidentiality objectives for the system outputs, and describe measures for achieving them. To illustrate the effect of the methods, we provide a comprehensive ex le comparing confidentialised output with traditional output for a range of common survival analyses. We believe that the confidentialised output of the remote analysis system for survival analysis as described in this paper is still useful for survival analysis in some situations, provided the user understands the confidentialisation process and its potential impact. If the remote analysis system user requires more detailed information such as outlier values, event times and/or and standard errors, then they would need to apply for access to the underlying data.
Publisher: Wiley
Date: 25-11-2005
DOI: 10.1111/J.1440-1754.2005.00756.X
Abstract: The diagnosis of sudden infant death syndrome (SIDS) has undergone several changes in definition since first being recognised as a cause of death. Linked total population data from Western Australia enable investigations to determine changes in classifications of mortality for the infants of Aboriginal and non-Aboriginal mothers (Aboriginal and Torres Strait Islander people are referred to throughout this report as 'Aboriginal'). Data for recent years show a shift away from a classification of 'SIDS' towards a classification of 'unascertainable', particularly for Aboriginal infants. This has implications for the accurate translation of data into policy and practice.
Publisher: Wiley
Date: 07-2010
DOI: 10.1111/J.1440-1754.2010.01752.X
Abstract: Aim: Describe breast‐ and bottle‐feeding patterns and the introduction of solid feeds and sugar containing drinks to the dietary intake of a cohort of urban Aboriginal infants in the first year of life. Methods: Two hundred and seventy‐four infants were recruited to a cohort study and information about infant nutrition was collected from their mothers during face to face interviews when the infants were aged 6–12 weeks, 7–8 months and 12 months old. Results: 88.3% of mothers initiated breast‐feeding, but only 43.8% of infants were exclusively breast‐fed at 6–12 weeks. By 12 months of age 69.8% of babies had received fruit juice in their bottles, 59.8% received cordial. 64.5% of infants were given water in their bottles. The majority of infants had received ‘fast foods’ by 12 months of age with 56.2% had been given coca cola, 68% lemonade and 78% fried chips. Conclusions: This study highlights areas in which nutrition health promotion can be targeted to prevent common childhood health problems including promoting and supporting mothers to sustain breast‐feeding and opportunities to reduce the sugar and fat intake among infants.
Publisher: Wiley
Date: 04-2022
DOI: 10.1111/IMJ.15090
Abstract: Indigenous populations have higher rates of diabetes and diabetic complications, yet there is a paucity of contemporary data on diabetic retinopathy (DR) prevalence and incidence in urban dwelling Aboriginal Australians. The aim of the study was to compare the prevalence of DR and incidence of new or worsening DR between Aboriginal Australians and Anglo‐Celts with Type 2 diabetes. Participants from the community‐based Fremantle Diabetes Study Phase II (817 Anglo‐Celts, 94 Aboriginal people) recruited between 2008 and 2011 underwent fundus photography at baseline and biennial reviews. The prevalence of any DR and moderate non‐proliferative DR (NPDR), and the incidence of new or worsening DR were ascertained using baseline and 4‐year follow‐up data. Compared with Anglo‐Celts, the Aboriginal participants had a higher prevalence of any DR (33.0% vs 52.1%) and moderate NPDR or worse (5.1% vs 24.4%), and new or worsening DR during follow up (6.7% vs 23.5%). The unadjusted odds ratios (95% confidence interval) of any DR and moderate NPDR at baseline were 2.21 (1.43, 3.39) and 5.98 (3.40, 10.50), respectively, and of new or worsening DR 4.32 (1.33, 13.98). In adjusted models, Aboriginal ethnicity was only associated with the prevalence of moderate NPDR or worse (5.58 (2.44, 12.76)). Aboriginal participants had a higher prevalence of DR and new or worsening DR, reflecting conventional risk factors including suboptimal glycaemic control. Their significantly higher odds of moderate NPDR or worse in adjusted models suggest ethnic‐specific determinants of DR severity. These findings highlight the need for equitable, culturally appropriate diabetes/ophthalmic care.
Publisher: Springer Science and Business Media LLC
Date: 04-06-2019
Publisher: Elsevier BV
Date: 06-2015
Publisher: BMJ
Date: 2017
Publisher: Springer Science and Business Media LLC
Date: 12-02-2016
Publisher: American Diabetes Association
Date: 11-09-2012
DOI: 10.2337/DC12-0225
Abstract: To determine whether disparities in the nature and management of type 2 diabetes persist between Aboriginal and the majority Anglo-Celt patients in an urban Australian community. Baseline data from the observational Fremantle Diabetes Study collected from 1993 to 1996 (phase I) and from 2008 to 2011 (phase II) were analyzed. Patients characterized as Aboriginal or Anglo-Celt by self-report and supporting data underwent comprehensive assessment, including questionnaires, examination, and biochemical testing in a single laboratory. Generalized linear modeling with age/sex adjustment was used to examine differences in changes in variables in the two groups between phases I and II. The indigenous participants were younger at entry and at diabetes diagnosis than the Anglo-Celt participants in both phases. They were also less likely to be educated beyond primary level and were more likely to be smokers. HbA1c decreased in both groups over time (Aboriginal median 9.6% [interquartile range 7.8–10.7%] to 8.4% [6.6–10.6%] vs. Anglo-Celt median 7.1% [6.2–8.4%] to 6.7% [6.2–7.5%]), but the gap persisted (P = 0.65 for difference between phases I and II by ethnic group). Aboriginal patients were more likely to have microvascular disease in both phases. The prevalence of peripheral arterial disease (ankle-brachial index ≤0.90 or lower-extremity utation) increased in Aboriginal but decreased in Anglo-Celt participants (15.8–29.7 vs. 30.7–21.5% P = 0.055). Diabetes management has improved for Aboriginal and Anglo-Celt Australian patients, but disparities in cardiovascular risk factors and complications persist.
Publisher: Emerald
Date: 15-06-2018
DOI: 10.1108/JHOM-02-2018-0056
Abstract: Continuous quality improvement (CQI) programmes have been taken up widely by indigenous primary health care services in Australia, but as yet there has not been a systematic assessment of their focus and achievements. A scoping review of the literature from studies of CQI in indigenous primary health care services was undertaken to explore impacts on service systems, care and client outcomes with the aim of providing guidance on future evaluation efforts. The paper aims to discuss these issues, Searches were conducted in MEDLINE, CINAHL and the Cochrane Database of Systematic Reviews to December 2016 and handsearching of key websites and publications. Studies of CQI programs or activities in Indigenous primary health care services which demonstrated some combination of CQI characteristics, as described by Rubenstein (2013) were included. A two-stage approach to analysis was undertaken. Stage 1 identified the range and scope of literature, and Stage 2 investigated impacts to service systems, care and client outcomes. The Framework for Performance Assessment in Primary Health Care was used to frame the Stage 2 analysis. The majority of Aboriginal community controlled health services have been involved in CQI but there are gaps in knowledge about uptake in general practice and government clinics. There are as many baseline studies as studies on impacts over time. Of the 14 studies included for further analysis, 6 reported on impacts on service systems all 14 reported on impacts on care and 6 on client outcomes. Changes to services systems are variable and studies of impacts on care and client outcomes show promising though uneven improvements. There are no economic studies or studies addressing community engagement in CQI activities. To supplement existing limited knowledge about which service system change strategies are effective and sustainable for which problems in which settings, there needs to be investment in research and development. Research needs to be grounded in the realities of service delivery and contribute to the development of CQI capacity at the service level. Knowledge translation needs to be built into implementation to ensure maximum benefit to those endeavouring on a daily basis to constantly reflect on and improve the quality of the care they deliver to clients, and to the stewardship structures supporting services at regional, state/territory and national levels. Improved approaches, methods, data capture and reporting arrangements are needed to enhance existing activity and to ensure maximum benefit to services endeavouring to reflect on and improve quality of care and to the stewardship structure supporting services at regional, state/territory and national levels. Although there is a growing body of research evidence about CQI both nationally and internationally, and considerable investment by the federal government in Australia to support CQI as part of routine practice, there has not been a systematic assessment of the achievements of CQI in Indigenous primary health care services. Many unanswered questions remain about the extent of uptake, implementation and impacts. This is a barrier to future investment and regional and local programme design, monitoring and evaluation. The authors conducted a scoping review to address these questions. From this, the authors draw conclusions about the state of knowledge in Australia with a view to informing how future CQI research and evaluation might be intensified.
Publisher: Springer Science and Business Media LLC
Date: 30-08-2019
Publisher: MDPI AG
Date: 28-01-2022
DOI: 10.3390/JCM11030695
Abstract: Background: Although rates of cardiovascular disease complicating type 2 diabetes are declining, equivalent data for renal replacement therapy (RRT) are conflicting. The aim of this study was to characterize temporal changes in RRT incidence rates (IRs) in Australians with or without type 2 diabetes. Methods: Participants with type 2 diabetes from the Fremantle Diabetes Study Phases I (FDS1 n = 1291 recruited 1993–1996) and II (FDS2 n = 1509 recruited 2008–2011) were age-, sex- and postcode-matched 1:4 to people without diabetes and followed for first hospitalization for/with RRT. Five-year IRs, IR ratios (IRRs) for those with versus without diabetes in FDS1 and FDS2, and IR differences (IRDs), were calculated. Results: The 13,995 participants had a mean age of 64.8 years and 50.4% were males. For the type 2 diabetes cohorts, the 5-year RRT IR was nearly threefold higher in FDS2 versus FDS1 (IRR (95% CI): 2.85 (1.01–9.87)). Sixteen more participants with type 2 diabetes/10,000 person-years received RRT in FDS2 than FDS1 compared with an IRD of 2/10,000 person-years in those without diabetes. Type 2 diabetes increased RRT risk at least 5-fold. This increased risk was greater in Aboriginal participants who were relatively young when RRT was initiated and more prone to rapid progression to RRT. Multivariable analysis using the combined FDS type 2 diabetes cohorts confirmed albuminuria as a strong independent RRT risk factor. Conclusions: The incidence of RRT is increasing substantially in Australians with type 2 diabetes, especially in Aboriginals who progress to RRT more rapidly at a younger age than non-Aboriginals.
Publisher: Canadian Science Publishing
Date: 02-2022
Abstract: Adequate fruit and vegetable intake is key to reducing chronic disease risk among Australian Aboriginal and Torres Strait Islander peoples. This rapid review collated evidence on healthy lifestyle initiatives that focused on increasing fruit and vegetable intake among Australian Aboriginal and Torres Strait Islander peoples residing in major cities. Due to limited studies conducted within major cities, we extended our inclusion criteria to regional and remote areas. Sixteen studies were included. Five (31%) studies were rated as good quality (least risk of bias), 10 (63%) studies were rated as fair, and 1 (6%) study was rated as poor (significant risk of bias). Five (31%) studies employed participatory research in the design and/or execution, and 7 (44%) studies included minimal community involvement. Only 5 (31%) studies were undertaken in major cities 4 of these combined major cities with regional and/or remote areas. All 5 studies reported positive findings, such as an increase in fresh fruit availability, usage of fresh vegetables, or self-reported fruit and vegetable intake. This review provides evidence confirming the need for high-quality healthy lifestyle initiatives to increase fruit and vegetable intake targeted at Aboriginal and Torres Strait Islander peoples living in major cities. This evidence will assist community organisations in designing effective health promotion interventions, providing insight into improving the structure and function of such programs. PROSPERO registration number: CRD42020194522. Novelty Five studies were undertaken in major cities and all reported positive findings only 1 study was rated as good quality. Presented data supports the need for high-quality studies to be conducted among those residing in major cities.
Publisher: Informa UK Limited
Date: 17-11-2022
Publisher: BMJ
Date: 03-2018
DOI: 10.1136/BMJOPEN-2017-021236
Abstract: Empirical evidence on family and community risk and protective factors influencing the comparatively high rates of potentially preventable hospitalisations and deaths among Aboriginal and Torres Strait Islander infants and children is limited. As is evidence on geographical variation in these risks. The ‘Defying the Odds’ study aims to explore the impact of perinatal outcomes, maternal social and health outcomes and level of culturally secure service availability on the health outcomes of Western Australian (WA) Aboriginal infants and children aged 0–5 years. The study combines a retrospective cohort study that uses state-wide linked health and administrative data from 12 data sources for multiple generations within Aboriginal families in WA, with specifically collected survey data from health and social services supporting Aboriginal families in regions of WA. Data sources include perinatal/birth registration, hospital, emergency department, mental health services, drug and alcohol service use, mortality, infectious disease notifications, and child protection and family services. Multilevel regression models will be used to examine the intensity of admissions and presentations, mortality, intensity of long stays and morbidity-free survival (no admissions) for Aboriginal children born in WA in 2000–2013. Relationships between maternal (and grand-maternal) health and social factors and child health outcomes will be quantified. Community-level variation in outcomes for Aboriginal children and factors contributing to this variation will be examined, including the availability of culturally secure services. Online surveys were sent to staff members at relevant services to explore the scope, reach and cultural security of services available to support Aboriginal families across selected regions of WA. Ethics approvals have been granted for the study. Interpretation and dissemination are guided by the study team’s Aboriginal leadership and reference groups. Dissemination will be through direct feedback and reports to health services in the study and via scientific publications and policy recommendations.
Publisher: JMIR Publications Inc.
Date: 10-12-2014
DOI: 10.2196/JMIR.3614
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/PY16096
Abstract: Otitis media is a common, generally self-limiting childhood illness that can progress to severe disease and have lifelong sequelae, including hearing loss and developmental delays. Severe disease is disproportionately prevalent among Aboriginal and Torres Strait Islander children. Primary health care is at the frontline of appropriate prevention and treatment. Continuous quality improvement in the prevention and management of important causes of morbidity in client populations is accepted best practice in primary health care and now a requirement of Australian Government funding to services providing care for Aboriginal and Torres Strait Islander children. To date, there have been no indicators for continuous quality improvement in the prevention and management of otitis media and its sequelae in primary health care. Through an expert group consensus process, seven evidence-based indicators, potentially extractable from electronic health records, have been developed. The development process and indicators are described.
Publisher: Springer Science and Business Media LLC
Date: 09-02-2018
Publisher: Informa UK Limited
Date: 03-11-2022
Publisher: Springer Science and Business Media LLC
Date: 28-08-2008
Publisher: Springer Science and Business Media LLC
Date: 02-07-2012
Publisher: Wiley
Date: 09-12-2020
DOI: 10.1111/PPE.12616
Start Date: 04-2021
End Date: 04-2025
Amount: $660,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 07-2020
End Date: 06-2023
Amount: $896,370.00
Funder: Australian Research Council
View Funded Activity