ORCID Profile
0000-0002-9401-5136
Current Organisations
Australian National University
,
Telethon Kids Institute
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Publisher: CSIRO Publishing
Date: 08-04-2022
DOI: 10.1071/PY21219
Abstract: In promoting positive cardiovascular health for Aboriginal and Torres Strait Islander peoples, there is a need to ensure provision of high-quality risk assessment and management in primary healthcare settings. There is some evidence of gender gaps for Australian women in the provision of cardiovascular risk assessment and management however, there is little understanding of whether these gaps are also present for Aboriginal and Torres Strait Islander women. A mixed-method systematic review was utilised to synthesise existing evidence on the provision of assessment and management against guideline-recommended care for Aboriginal and Torres Strait Islander women, and determine whether gender disparities in provision of care exist for this population. Sixteen studies that report gender-specific data indicate there are significant gaps in the provision of assessment and management for Aboriginal and Torres Strait Islander women and men alike. There is no evidence of incorporation of social and emotional wellbeing into cardiovascular care and limited studies outlining the assessment and management of behaviours and factors that may be protective of cardiovascular health. Furthermore, little is known about the provision of care in mainstream primary health services for Aboriginal and Torres Strait Islander peoples.
Publisher: Elsevier BV
Date: 2021
Publisher: Elsevier BV
Date: 09-2021
Publisher: Elsevier BV
Date: 2018
Publisher: Elsevier BV
Date: 2021
Publisher: Elsevier BV
Date: 08-2016
Publisher: Elsevier BV
Date: 2019
Publisher: AMPCo
Date: 09-2016
DOI: 10.5694/MJA16.00445
Abstract: To assess differences in the rates of angiography and subsequent revascularisation for Aboriginal and non-Aboriginal South Australians who presented with an acute coronary syndrome (ACS) to explore the reasons for any observed differences. Analysis of administrative data with logistic regression modelling to assess the relationship between Aboriginal status and the decision to undertake diagnostic angiography. A detailed medical record review of Aboriginal admissions was subsequently undertaken. Emergency ACS admissions to SA cardiac catheterisation hospitals, 2007-2012. 13 701 admissions of patients with an ACS, including 274 Aboriginal patients (2.1%). Rates of coronary angiography and revascularisation documentation of justification for non-invasive management. After adjustment for age, comorbidities and remoteness, Aboriginal patients presenting with an ACS were significantly less likely than non-Aboriginal patients to undergo angiography (odds ratio [OR], 0.4 95% CI, 0.3-0.5 P < 0.001). There was no significant difference in the rates of revascularisation for Aboriginal and non-Aboriginal patients who had undergone angiography. Reasons for Aboriginal patients not undergoing angiography included symptoms being deemed non-cardiac (16%), non-invasive test performed (8%), and discharge against medical advice (11%) the reasons were unclear for 36% of Aboriginal patients. After controlling for age and other factors, the rate of coronary angiography was lower among Aboriginal patients with an ACS in SA. The reasons for this disparity are complex, including patient-related factors and their preferences, as well as the appropriateness of the intervention. Improved consideration of the hospital experience of Aboriginal patients must be a priority for reducing health care disparities.
Publisher: Elsevier BV
Date: 08-2016
Publisher: Elsevier BV
Date: 2019
Publisher: Elsevier BV
Date: 08-2016
Publisher: Informa UK Limited
Date: 28-06-2022
DOI: 10.1080/10749357.2021.1911771
Abstract: Aboriginal and Torres Strait Islander (hereinafter respectfully termed Aboriginal) people have a greater incidence of stroke at a younger age than non-Indigenous people in Australia. The needs and preferences of Aboriginal people for rehabilitation and longer-term support remain largely unknown. To identify the long-term rehabilitation needs of Aboriginal people who have a stroke, from the perspectives of Aboriginal persons with stroke and health care providers. Aboriginal people who had experienced stroke in the previous three years were interviewed to obtain their experiences of rehabilitation care. Health professionals who provided care in each of six designated hospitals and nearby community health sites were involved in focus groups and in idual interviews. Information obtained was thematically analyzed separately for Aboriginal people with stroke and health professionals, and compared using Nvivo. Among six Aboriginal people with stroke and 78 healthcare providers, four main themes emerged: the importance of family variable access to services the impact of stroke on Aboriginal peoples' lives and making positive choices. Communication and involvement of family was highlighted as essential for a shared understanding, particularly when making decisions about participating in short and long-term rehabilitation. Co-morbidities, conflicting priorities, and inadequate or inflexible services and transport compounded issues with changing life roles. Stories of resilience were also shared. Aboriginal people report making positive lifestyle changes, but experience significant unmet rehabilitation needs. Addressing issues of communication, advocacy and flexible delivery should improve some of the shortfalls in service provision, particularly in regional and remote areas.
Publisher: Elsevier BV
Date: 2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2014
Publisher: Elsevier BV
Date: 2017
Publisher: Ubiquity Press, Ltd.
Date: 03-2014
Publisher: Elsevier BV
Date: 2017
Publisher: Ubiquity Press, Ltd.
Date: 03-2014
Publisher: Wiley
Date: 29-06-2023
DOI: 10.1002/HPJA.765
Abstract: The Wellbeing Economy, which places human and ecological wellbeing at the centre of policy making, aligns with holistic Aboriginal and Torres Strait Islander conceptualisations of health and wellbeing. In order to address chronic diseases in South Australian Aboriginal and Torres Strait Islander populations, the South Australian Aboriginal Chronic Disease Consortium (Consortium) is fostering action in ways that align both with the Wellbeing Economy and with Health in All Policies (HiAP) approaches. In June 2017, the Consortium was established as a collaborative partnership between government and non‐government organisations, researchers, Aboriginal organisations and communities to lead the effective implementation of three state‐wide chronic disease plans. A coordinating centre was funded to support and progress the work of the Consortium. During its first 5 years, the Consortium has developed a foundation for sustained system reform through partnering with stakeholders, leading projects and initiatives, advocating for key priorities, leveraging existing infrastructure and funding, supporting services, and coordinating delivery of priority actions using innovative approaches. Through the Consortium governance structure, Aboriginal and Torres Strait Islander community members, policy actors, service providers and researchers oversee, drive, influence and support the implementation of priority action initiatives. Sustained funding, competing priorities of partner organisations and project evaluation are constant challenges. A consortium approach provides direction and shared priorities, which foster collaboration across and between organisations, service providers and the Aboriginal community. Aligning with HiAP approaches and the Wellbeing Economy, it harnesses knowledge, networks and partnerships that support project implementation and reduce duplication.
Publisher: Elsevier BV
Date: 2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2014
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/AH17290
Abstract: Objective The aim of this study was to describe the experiences of communication for staff providing cardiac care for Aboriginal and Torres Strait Islander patients in hospital and discuss potential improvements. Methods Focus group discussions were performed with 58 multidisciplinary staff who provide care for Aboriginal and Torres Strait Islander cardiac patients in two metropolitan and two regional hospitals in South Australia and Northern Territory. Inductive thematic analysis was undertaken to identify staff perceptions of communication challenges and strategies for improvement. Results There were five key themes: (1) communication is central to good care (2) communication within busy clinical environments (3) supporting a strong Aboriginal workforce (4) a cultural as well as clinical focus and (5) particular challenges working with patients from remote areas. Conclusions Providing effective communication that is both clinically and culturally appropriate is often challenging within a busy and non-adaptive hospital environment. Moving beyond clinical tasks, increased Aboriginal and Torres Strat Islander health workforce and cultural competency, supporting coordinated care and improved skills are required to meet the communication needs of Aboriginal and Torres Strait Islander patients. What is known about this topic? Communication between patients, their families and hospital staff is crucial for health care quality and safety. There is little understanding of the challenges and opportunities for staff to meet the communication needs of Aboriginal and Torres Strait Islander cardiac patients to address disparities in acute care settings. What does this paper add? This paper discusses the barriers and potential improvements, as identified by hospital staff providing care to Aboriginal and Torres Strait Islander cardiac patients in both metropolitan and regional settings. What are the implications for practitioners? Practitioners should be trained and supported in providing both clinically and culturally safe care for Aboriginal and Torres Strait Islander patients. This requires adequate time, two-way communication and resources to support and facilitate effective communication.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2016
DOI: 10.11124/JBISRIR-2016-003163
Abstract: The objective of this systematic review is to identify and synthesize available qualitative evidence to understand the in-hospital communication experiences of Aboriginal and Torres Strait Islander adults, their family members and hospital staff, and the factors that impact on these experiences. Specifically, the review questions are as follows: What are the communication experiences of Australian Aboriginal and Torres Strait Islander adults and their family members when they interact with hospital staff? What are the communication experiences of hospital staff when they interact with Australian Aboriginal and Torres Strait Islander adults and their family members? What are the factors that influence these communication experiences?
Publisher: Wiley
Date: 05-2017
DOI: 10.1111/IMJ.1_13457
Publisher: Elsevier BV
Date: 2019
Publisher: Elsevier BV
Date: 2021
Publisher: SAGE Publications
Date: 08-2017
Publisher: Elsevier BV
Date: 2021
Publisher: Elsevier BV
Date: 08-2016
Publisher: CSIRO Publishing
Date: 19-08-2022
DOI: 10.1071/PY22064
Abstract: Background For Aboriginal and Torres Strait Islander women, the premature burden of cardiovascular disease is affecting their capacity to fulfil roles in society, and promote the health and wellbeing of future generations. In Australia, there is limited understanding of the difference in primary preventive cardiovascular care experienced by women, despite knowledge of sex and gender differentials in health profile and receipt of guideline-based acute care. This paper sought to explore the health profile and receipt of assessment and management of cardiovascular risk for Aboriginal and Torres Strait Islander women accessing preventive primary health care, and investigate gender differentials. Method Records of 1200 current clients, 50% women, aged 18–74 years from three Aboriginal Health Services in central and South Australia for the period 7/2018–6/2020 were reviewed. Results Twelve percent had documented cardiovascular disease. Compared with men, women with no recorded cardiovascular disease had a greater likelihood of being overweight or obese, a waist circumference indicative of risk, diabetes, and depression. Women were less likely to report being physically active. Conclusions The research concluded that gaps exist in the provision and recording of guideline-recommended primary preventive care regardless of sex. These are stark, given the evident burden.
Publisher: BMJ
Date: 10-2020
DOI: 10.1136/BMJOPEN-2020-039533
Abstract: We aimed to compare the incidence, subtypes and aetiology of stroke, and in-hospital death due to stroke, between Aboriginal and non-Aboriginal people in Central Australia, a remote region of Australia where a high proportion Aboriginal people reside (40% of the population). We hypothesised that the rates of stroke, particularly in younger adults, would be greater in the Aboriginal population, compared with the non-Aboriginal population we aimed to elucidate causes for any identified disparities. A retrospective population-based study of patients hospitalised with stroke within a defined region from 1 January 2011 to 31 December 2014. Alice Springs Hospital, the only neuroimaging-capable acute hospital in Central Australia, serving a network of 50 healthcare facilities covering 672 000 km 2 . 161 residents (63.4% Aboriginal) of the catchment area admitted to hospital with stroke. Rates of first-ever stroke, overall (all events) stroke and in-hospital death. Of 121 residents with first-ever stroke, 61% identified as Aboriginal. Median onset-age (54 years) was 17 years younger in Aboriginal patients (p .001), and age-standardised stroke incidence was threefold that of non-Aboriginal patients (153 vs 51 per 100 000, incidence rate ratio 3.0, 95% CI 2 to 4). The rate ratios for the overall rate of stroke (first-ever and recurrent) were similar. In Aboriginal patients aged years, the incidence of ischaemic stroke was 14-fold greater (95% CI 4 to 45), and intracerebral haemorrhage 19-fold greater (95% CI 3 to 142) than in non-Aboriginal patients. Crude prevalence of diabetes mellitus (70.3% vs 34.0%, p .001) and hypercholesterolaemia (68.9% vs 51.1%, p=0.049) was greater, and age-standardised in-hospital deaths were fivefold greater (35 vs 7 per 100 000, 95% CI 2 to 11) in Aboriginal patients than in non-Aboriginal patients. Stroke incidence (both subtypes) and in-hospital deaths for remote Aboriginal Australians are dramatically greater than in non-Aboriginal people, especially in patients aged years.
Publisher: Informa UK Limited
Date: 22-12-2023
Location: Australia
Start Date: 2017
End Date: 2019
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2023
End Date: 2025
Funder: National Heart Foundation of Australia
View Funded Activity