Cath Brown - Academia.edu (original) (raw)

Papers by Cath Brown

The Australian Universities' review, 2014

Considering the benefits that enterprise agreements (EAs) can bring to Indigenous employees, this... more Considering the benefits that enterprise agreements (EAs) can bring to Indigenous employees, this paper considers the question of whether respectful cultural policies that are aligned with reconciliation and included in EAs can be achieved to Close the Gap on reducing Indigenous disadvantage. A document analysis of EAs at eight Australian universities was conducted to conceptualise and compare information about Indigenous staff needs and remuneration. A number of specific sections relating to Indigenous employment and leave arrangements were identified.

This publication is one of five that report on the work of the Funding, Accountability and Result... more This publication is one of five that report on the work of the Funding, Accountability and Results (FAR) project, all published by the Lowitja Institute in 2015. The research reported here, in summary form, is a study of reforms in primary health care for Aboriginal and Torres Strait Islander communities in the Northern Territory (between 2009 and 2014) and Cape York, Queensland (between 2006 and 2014). In both places, the intention of the reforms was twofold: to establish a regional system of PHC provision with reliable access to care for all Aboriginal and Torres Strait Islander communities in the regions, and to increase community control of health care by transferring some or most of the responsibility for providing PHC from government health authorities to regional Aboriginal Community Controlled Health Organisations (ACCHOs). These were bold plans with long histories of development in both jurisdictions.

In the context of Australia's strategy to Close the Gap on Indigenous disadvantage in employm... more In the context of Australia's strategy to Close the Gap on Indigenous disadvantage in employment, this paper tells my personal story as an example of the challenges that Aboriginal people face in moving to new jobs and to face new responsibilities. In my case, I became employed as a researcher in the Empowerment Research Program of James Cook University (JCU) in Cairns and a facilitator in the related Aboriginal developed Family Wellbeing Empowerment Program. As the first paper in a two-part series, this paper explores why change and the unknown had a large part to do with my reluctance to move to new jobs, and the rewards of facing my fears. The second paper will describe the opportunities and challenges associated with facilitating the Family Wellbeing program. Both papers are based on reflections written during the training and facilitation processes over the last couple of years. I used thematic analysis to code the reflections and identify themes. I reviewed the themes and created a mind map to see how the themes related to each other. This paper concludes that becoming personally empowered through meaningful employment is an ongoing process involving both personal courage and a supportive environment.

Patient Preference and Adherence

Understanding and responding to the supportive care needs of people with cirrhosis is essential t... more Understanding and responding to the supportive care needs of people with cirrhosis is essential to quality care. Indigenous Australians, Aboriginal and Torres Strait Islander people, are overrepresented amongst patients with cirrhosis. This study documented the nature and extent of supportive care needs of Indigenous Australians with cirrhosis, in comparison with non-Indigenous Australians. Patients and Methods: The supportive care needs of adult patients diagnosed with cirrhosis attending public hospitals in Queensland were assessed through the Supportive Needs Assessment tool for Cirrhosis (SNAC). Patients indicated how much additional help they needed on four subscales: 1. psychosocial issues; 2. practical and physical needs; 3. information needs; and 4. lifestyle changes. We examined the rate of moderate-to-high unmet needs based on Indigenous status (Poisson regression; incidence rate ratio (IRR)). Results: Indigenous (n=20) and non-Indigenous (n=438) patients included in the study had similar sociodemographic and clinical characteristics except for a lower educational level among Indigenous patients (p<0.01). Most Indigenous patients (85.0%) reported having moderate-tohigh unmet needs with at least one item in the SNAC tool. Following adjustment for key sociodemographic and clinical factors, Indigenous patients had a greater rate of moderate-tohigh unmet needs overall (IRR=1.5, 95% CI 1.31-1.72; p<0.001), and specifically for psychosocial issues (IRR=1.7, 95% CI 1.39-2.15; p<0.001), and practical and physical needs subscales (IRR=1.5, 95% CI 1.22-1.83; p<0.001), compared to non-Indigenous patients. Conclusion: Indigenous Australians with cirrhosis more frequently had moderate-to-high unmet supportive care needs than non-Indigenous patients. Specific targeting of culturally appropriate supportive care for psychosocial, practical and physical needs may optimize cirrhosis care and improve the quality of life for Indigenous Australians with cirrhosis.

[Extract] Government and public debate has focused on the problems with small remote outback comm... more [Extract] Government and public debate has focused on the problems with small remote outback communities, and what seems like a lack of sustainability and vitality. Few people ask community members how they see sustainable living and what solutions they might develop if empowered to do so. To this end, an empowerment program has been run in Alice Springs for many years: the Family Wellbeing Program This provides Aboriginal people with key directions toward social, emotional and spiritual wellbeing that in turn enable them to rebuild their lives, social strength and stability – all essential foundations to a sustainable community.

Much documentation exists regarding the causes and contemporary circumstances of Australian Abori... more Much documentation exists regarding the causes and contemporary circumstances of Australian Aboriginal health and wellbeing; measurements of compromised health and wellbeing are abundant and long-standing. However, there is little published evidence-based research that captures the intricacies of the processes involved in promoting initiatives to enhance Aboriginal health and wellbeing. Advocacy by international development and aid communities over recent decades has supported ecological bottom-up solutions, including participatory and empowerment strategies to promote sustainable social development and change. In reality, the approach represents a major challenge to implement. This presentation illustrates the approach taken by a multi-disciplinary research team in Far North Queensland led by Professor Komla Tsey. Over the past decade, the research team has operationalised an Aboriginal-developed empowerment education program at the personal/family, group/organisational and communi...

The International Journal of Health, Wellness, and Society, 2011

The effective model assumption based on the average field theory has been modified and extended t... more The effective model assumption based on the average field theory has been modified and extended to investigate the effects of interfacial parameters including the bonding strength and interfacial thickness on the yield strength of particle reinforced composites. The formulation is applied to a model case of SiC particle reinforced Al matrix composite. The theoretical results agree well with the experimental ones of the SiC/Al composite produced by a PM route. The modified theoretical model can effectively predict the interfacial behavior and provide the preparation of SiC/Al composites with scientific foundation to control the interfaces.

Strengthening the two-way organisational capacity of both Indigenous and government organisations... more Strengthening the two-way organisational capacity of both Indigenous and government organisations is critical to raising the health, wellbeing and prosperity of Indigenous Australian communities. A review of the Indigenous Australian literature across seven databases using multiple search terms suggested that improving governance processes is likely to require incremental strengthening of Indigenous and government organisational values, goals, structures and arrangements that influence employees’ and clients' behaviour and wellbeing. Involvement of Indigenous people in leading decision-making about their own development was critical. The literature cited effective approaches as tailored to specific situations, utilising existing community capacity and based on Indigenous community ownership of governance-improvement. Similarly, there is evidence for collaborative approaches between Indigenous people and governments that strengthen existing capacity through long-term partnering. What is important is that capacity strengthening programs have clarity of purpose; being explicit about their intent to strengthen capacity for what and for whom, and how we know their effects? In contrast, the literature cites detrimental approaches for governance including programs that do not reflect community priorities, attempts to improve Indigenous governance structures, such as through amalgamation, without attending to governance processes, fragmented, rapidly changing, ad hoc and poorly coordinated government processes, and multiple accountability requirements (red tape).

There is little empirical evidence about the effectiveness of community efforts, including commun... more There is little empirical evidence about the effectiveness of community efforts, including community governance improvement and capacity strengthening tailored toward societal change within the broader structural environment. This paper presents the results of a twelve month community-based participatory research project initiated by, and undertaken in a discrete Aboriginal community in Far North Queensland, Australia. Working from the principles of community-based participatory research, a group of community-based health and social welfare stakeholders reflected on their practice, community issues and research evidence to inform a community action plan for social and emotional wellbeing. Grounded theory methods were used to analyze the data sourced from meeting minutes, topics workshopped with the group, reflective group sessions and researcher observations and reflections. The importance of strengthening local governance and capacity, and taking empowerment approaches in achieving community change were highlighted as shaping successful practice.

Contemporary Nurse, 2013

R esearchers working with Aboriginal Australian communities are inherently faced with a range of ... more R esearchers working with Aboriginal Australian communities are inherently faced with a range of unique historical, socio-cultural and political complexities that challenge conventional research approaches (Bainbridge, Whiteside, & McCalman, 2013). Undertaking palliative care research with Aboriginal Australians in a remote setting is even more demanding. Regardless of whether the researcher is located within or outside their cultural environments, or using amenable methodological approaches, practice imperatives are amplified in such complicated and sensitive contexts (Bainbridge, Whiteside, et al., 2013). Processes aimed at promoting research to meet the aspirations of Aboriginal Australians have long been advocated locally and globally by Indigenous scholars and communities; and funding bodies have developed research frameworks to uphold such practices. These ethical practice principles have been advanced in research institutions, and communitybased participatory research approaches recognised as important for improving policy-making, health care and health outcomes for Aboriginal Australians at regional and national levels. But there is negligible documentation in the health literature about

Darwin, James Cook University.[URL] Desert, …, 2009

The concept of social and emotional wellbeing articulated within the national social and emotiona... more The concept of social and emotional wellbeing articulated within the national social and emotional wellbeing framework (Commonwealth of Australia 2004) is an important attempt to merge the population health paradigm and an Indigenous worldview in which ...

Health Promotion Journal of Australia, 2020

ISSUE ADDRESSED Health promotion, the process of enabling people to increase control over their h... more ISSUE ADDRESSED Health promotion, the process of enabling people to increase control over their health, implies advocacy and empowerment on behalf of others. This does not account for the phenomena whereby Aboriginal and Torres Strait Islander people have advocated to strengthen the determinants of their own and their communities' health. This paper provides a systematic scoping review of the published literature that documents Aboriginal and Torres Strait Islander advocacy to improve community empowerment during the time 1940-1970. The objectives of the review were to establish: 1. The extent to which Aboriginal and Torres Strait Islander advocacy has been documented; 2. The extent to which the literature is written from an Aboriginal and Torres Strait Islander perspective; 3. The extent to which local community-level advocacy has been documented; and 4. How advocacy occurred. METHODS The Informit database was systematically searched, publications selected against inclusion criteria, and themes synthesised to map key concepts, types of evidence, and gaps in research. RESULTS Based on this systematic search, 30 papers were found. The four key themes identified were: individual advocates, black organisations, international solidarity, and black and white people working together. CONCLUSIONS Despite the many gaps in the literature, there is documented evidence of considerable outcomes from advocacy. SO WHAT?: The concept of advocacy and indeed, health promotion itself, may need to be decolonized, and that the concept of 'everyday resistance' may more accurately encompass the diverse repertoire of actions which took place between agents of resistance and agents of dominant power.

Education, training and employment have been identified in the last decade as a key priority for ... more Education, training and employment have been identified in the last decade as a key priority for improving Indigenous outcomes. A huge gap exists in the relationships between the social determinants of health and the health outcomes experienced by Indigenous Australians. If we are to close the gap on these inequalities, and improve health and wellbeing, key strategies must include more Indigenous representation in social and emotional wellbeing training. As the second paper in a three-part series, this paper describes the opportunities and challenges associated with the process of gaining personal empowerment and training to better help Indigenous communities. After I took the difficult first step of deciding to commit to the pathway of education training and a better job, I trained as a Family Wellbeing (FWB) facilitator and I am now involved in passing on these skills to others. The Aboriginal-developed Family Wellbeing Program works toward improving self-esteem and confidence of ...

The Australian Universities' review, 2014

Considering the benefits that enterprise agreements (EAs) can bring to Indigenous employees, this... more Considering the benefits that enterprise agreements (EAs) can bring to Indigenous employees, this paper considers the question of whether respectful cultural policies that are aligned with reconciliation and included in EAs can be achieved to Close the Gap on reducing Indigenous disadvantage. A document analysis of EAs at eight Australian universities was conducted to conceptualise and compare information about Indigenous staff needs and remuneration. A number of specific sections relating to Indigenous employment and leave arrangements were identified.

This publication is one of five that report on the work of the Funding, Accountability and Result... more This publication is one of five that report on the work of the Funding, Accountability and Results (FAR) project, all published by the Lowitja Institute in 2015. The research reported here, in summary form, is a study of reforms in primary health care for Aboriginal and Torres Strait Islander communities in the Northern Territory (between 2009 and 2014) and Cape York, Queensland (between 2006 and 2014). In both places, the intention of the reforms was twofold: to establish a regional system of PHC provision with reliable access to care for all Aboriginal and Torres Strait Islander communities in the regions, and to increase community control of health care by transferring some or most of the responsibility for providing PHC from government health authorities to regional Aboriginal Community Controlled Health Organisations (ACCHOs). These were bold plans with long histories of development in both jurisdictions.

In the context of Australia's strategy to Close the Gap on Indigenous disadvantage in employm... more In the context of Australia's strategy to Close the Gap on Indigenous disadvantage in employment, this paper tells my personal story as an example of the challenges that Aboriginal people face in moving to new jobs and to face new responsibilities. In my case, I became employed as a researcher in the Empowerment Research Program of James Cook University (JCU) in Cairns and a facilitator in the related Aboriginal developed Family Wellbeing Empowerment Program. As the first paper in a two-part series, this paper explores why change and the unknown had a large part to do with my reluctance to move to new jobs, and the rewards of facing my fears. The second paper will describe the opportunities and challenges associated with facilitating the Family Wellbeing program. Both papers are based on reflections written during the training and facilitation processes over the last couple of years. I used thematic analysis to code the reflections and identify themes. I reviewed the themes and created a mind map to see how the themes related to each other. This paper concludes that becoming personally empowered through meaningful employment is an ongoing process involving both personal courage and a supportive environment.

Patient Preference and Adherence

Understanding and responding to the supportive care needs of people with cirrhosis is essential t... more Understanding and responding to the supportive care needs of people with cirrhosis is essential to quality care. Indigenous Australians, Aboriginal and Torres Strait Islander people, are overrepresented amongst patients with cirrhosis. This study documented the nature and extent of supportive care needs of Indigenous Australians with cirrhosis, in comparison with non-Indigenous Australians. Patients and Methods: The supportive care needs of adult patients diagnosed with cirrhosis attending public hospitals in Queensland were assessed through the Supportive Needs Assessment tool for Cirrhosis (SNAC). Patients indicated how much additional help they needed on four subscales: 1. psychosocial issues; 2. practical and physical needs; 3. information needs; and 4. lifestyle changes. We examined the rate of moderate-to-high unmet needs based on Indigenous status (Poisson regression; incidence rate ratio (IRR)). Results: Indigenous (n=20) and non-Indigenous (n=438) patients included in the study had similar sociodemographic and clinical characteristics except for a lower educational level among Indigenous patients (p<0.01). Most Indigenous patients (85.0%) reported having moderate-tohigh unmet needs with at least one item in the SNAC tool. Following adjustment for key sociodemographic and clinical factors, Indigenous patients had a greater rate of moderate-tohigh unmet needs overall (IRR=1.5, 95% CI 1.31-1.72; p<0.001), and specifically for psychosocial issues (IRR=1.7, 95% CI 1.39-2.15; p<0.001), and practical and physical needs subscales (IRR=1.5, 95% CI 1.22-1.83; p<0.001), compared to non-Indigenous patients. Conclusion: Indigenous Australians with cirrhosis more frequently had moderate-to-high unmet supportive care needs than non-Indigenous patients. Specific targeting of culturally appropriate supportive care for psychosocial, practical and physical needs may optimize cirrhosis care and improve the quality of life for Indigenous Australians with cirrhosis.

[Extract] Government and public debate has focused on the problems with small remote outback comm... more [Extract] Government and public debate has focused on the problems with small remote outback communities, and what seems like a lack of sustainability and vitality. Few people ask community members how they see sustainable living and what solutions they might develop if empowered to do so. To this end, an empowerment program has been run in Alice Springs for many years: the Family Wellbeing Program This provides Aboriginal people with key directions toward social, emotional and spiritual wellbeing that in turn enable them to rebuild their lives, social strength and stability – all essential foundations to a sustainable community.

Much documentation exists regarding the causes and contemporary circumstances of Australian Abori... more Much documentation exists regarding the causes and contemporary circumstances of Australian Aboriginal health and wellbeing; measurements of compromised health and wellbeing are abundant and long-standing. However, there is little published evidence-based research that captures the intricacies of the processes involved in promoting initiatives to enhance Aboriginal health and wellbeing. Advocacy by international development and aid communities over recent decades has supported ecological bottom-up solutions, including participatory and empowerment strategies to promote sustainable social development and change. In reality, the approach represents a major challenge to implement. This presentation illustrates the approach taken by a multi-disciplinary research team in Far North Queensland led by Professor Komla Tsey. Over the past decade, the research team has operationalised an Aboriginal-developed empowerment education program at the personal/family, group/organisational and communi...

The International Journal of Health, Wellness, and Society, 2011

The effective model assumption based on the average field theory has been modified and extended t... more The effective model assumption based on the average field theory has been modified and extended to investigate the effects of interfacial parameters including the bonding strength and interfacial thickness on the yield strength of particle reinforced composites. The formulation is applied to a model case of SiC particle reinforced Al matrix composite. The theoretical results agree well with the experimental ones of the SiC/Al composite produced by a PM route. The modified theoretical model can effectively predict the interfacial behavior and provide the preparation of SiC/Al composites with scientific foundation to control the interfaces.

Strengthening the two-way organisational capacity of both Indigenous and government organisations... more Strengthening the two-way organisational capacity of both Indigenous and government organisations is critical to raising the health, wellbeing and prosperity of Indigenous Australian communities. A review of the Indigenous Australian literature across seven databases using multiple search terms suggested that improving governance processes is likely to require incremental strengthening of Indigenous and government organisational values, goals, structures and arrangements that influence employees’ and clients' behaviour and wellbeing. Involvement of Indigenous people in leading decision-making about their own development was critical. The literature cited effective approaches as tailored to specific situations, utilising existing community capacity and based on Indigenous community ownership of governance-improvement. Similarly, there is evidence for collaborative approaches between Indigenous people and governments that strengthen existing capacity through long-term partnering. What is important is that capacity strengthening programs have clarity of purpose; being explicit about their intent to strengthen capacity for what and for whom, and how we know their effects? In contrast, the literature cites detrimental approaches for governance including programs that do not reflect community priorities, attempts to improve Indigenous governance structures, such as through amalgamation, without attending to governance processes, fragmented, rapidly changing, ad hoc and poorly coordinated government processes, and multiple accountability requirements (red tape).

There is little empirical evidence about the effectiveness of community efforts, including commun... more There is little empirical evidence about the effectiveness of community efforts, including community governance improvement and capacity strengthening tailored toward societal change within the broader structural environment. This paper presents the results of a twelve month community-based participatory research project initiated by, and undertaken in a discrete Aboriginal community in Far North Queensland, Australia. Working from the principles of community-based participatory research, a group of community-based health and social welfare stakeholders reflected on their practice, community issues and research evidence to inform a community action plan for social and emotional wellbeing. Grounded theory methods were used to analyze the data sourced from meeting minutes, topics workshopped with the group, reflective group sessions and researcher observations and reflections. The importance of strengthening local governance and capacity, and taking empowerment approaches in achieving community change were highlighted as shaping successful practice.

Contemporary Nurse, 2013

R esearchers working with Aboriginal Australian communities are inherently faced with a range of ... more R esearchers working with Aboriginal Australian communities are inherently faced with a range of unique historical, socio-cultural and political complexities that challenge conventional research approaches (Bainbridge, Whiteside, & McCalman, 2013). Undertaking palliative care research with Aboriginal Australians in a remote setting is even more demanding. Regardless of whether the researcher is located within or outside their cultural environments, or using amenable methodological approaches, practice imperatives are amplified in such complicated and sensitive contexts (Bainbridge, Whiteside, et al., 2013). Processes aimed at promoting research to meet the aspirations of Aboriginal Australians have long been advocated locally and globally by Indigenous scholars and communities; and funding bodies have developed research frameworks to uphold such practices. These ethical practice principles have been advanced in research institutions, and communitybased participatory research approaches recognised as important for improving policy-making, health care and health outcomes for Aboriginal Australians at regional and national levels. But there is negligible documentation in the health literature about

Darwin, James Cook University.[URL] Desert, …, 2009

The concept of social and emotional wellbeing articulated within the national social and emotiona... more The concept of social and emotional wellbeing articulated within the national social and emotional wellbeing framework (Commonwealth of Australia 2004) is an important attempt to merge the population health paradigm and an Indigenous worldview in which ...

Health Promotion Journal of Australia, 2020

ISSUE ADDRESSED Health promotion, the process of enabling people to increase control over their h... more ISSUE ADDRESSED Health promotion, the process of enabling people to increase control over their health, implies advocacy and empowerment on behalf of others. This does not account for the phenomena whereby Aboriginal and Torres Strait Islander people have advocated to strengthen the determinants of their own and their communities' health. This paper provides a systematic scoping review of the published literature that documents Aboriginal and Torres Strait Islander advocacy to improve community empowerment during the time 1940-1970. The objectives of the review were to establish: 1. The extent to which Aboriginal and Torres Strait Islander advocacy has been documented; 2. The extent to which the literature is written from an Aboriginal and Torres Strait Islander perspective; 3. The extent to which local community-level advocacy has been documented; and 4. How advocacy occurred. METHODS The Informit database was systematically searched, publications selected against inclusion criteria, and themes synthesised to map key concepts, types of evidence, and gaps in research. RESULTS Based on this systematic search, 30 papers were found. The four key themes identified were: individual advocates, black organisations, international solidarity, and black and white people working together. CONCLUSIONS Despite the many gaps in the literature, there is documented evidence of considerable outcomes from advocacy. SO WHAT?: The concept of advocacy and indeed, health promotion itself, may need to be decolonized, and that the concept of 'everyday resistance' may more accurately encompass the diverse repertoire of actions which took place between agents of resistance and agents of dominant power.

Education, training and employment have been identified in the last decade as a key priority for ... more Education, training and employment have been identified in the last decade as a key priority for improving Indigenous outcomes. A huge gap exists in the relationships between the social determinants of health and the health outcomes experienced by Indigenous Australians. If we are to close the gap on these inequalities, and improve health and wellbeing, key strategies must include more Indigenous representation in social and emotional wellbeing training. As the second paper in a three-part series, this paper describes the opportunities and challenges associated with the process of gaining personal empowerment and training to better help Indigenous communities. After I took the difficult first step of deciding to commit to the pathway of education training and a better job, I trained as a Family Wellbeing (FWB) facilitator and I am now involved in passing on these skills to others. The Aboriginal-developed Family Wellbeing Program works toward improving self-esteem and confidence of ...