Health and wellbeing outcomes of programs for Indigenous Australians that include strategies to enable the expression of cultural identities: a systematic review (original) (raw)
Related papers
Toward health and wellbeing for indigenous Australians
Postgraduate Medical Journal, 2005
The health of indigenous Australians remains well below that of non-indigenous Australians and indigenous peoples in Canada and New Zealand. Although recent planning has initiated many outstanding, culturally appropriate programmes with indigenous involvement, health statistics only reflect marginal improvement in recent years. It is crucial that positive programmes are sustained with appropriately directed funding. An approach that includes respect for the emotional and spiritual wellbeing of Australia's indigenous peoples will assist to redress some of the disadvantage caused by dispossession of country, language, and identity. It is clear from many programmes that are in place, that primary health care delivered locally through community controlled organisations, will minimise the impact of serious illnesses that currently threaten whole families and communities. Westernised health care systems are slow to learn from indigenous peoples in Australia and other places, that maintenance of wellness, not management of illness should be the goal.
Successful chronic disease care for Aboriginal Australians requires cultural competence
Australian and New Zealand Journal of Public Health, 2011
A boriginal and Torres Strait Islander people (hencefor th refer red to as Aboriginal people) have significantly higher morbidity and lower life expectancy than non-Aboriginal Australians. Recent estimates of Aboriginal life expectancy are 11.5 years (males) and 9.7 years (females) less than non-Aboriginal Australians. 1 Their poorer health has been attributed to multiple factors, including high levels of social, educational and economic disadvantage, 2 possible genetic predisposition for diabetes 3 and exposure to infectious diseases, alcohol, and a high-fat and high-sugar Western diet. 4 A wide variety of clinical and non-clinical solutions, and a long-term commitment by governments are necessary to resolve these issues. 5 Following the 2005 Social Justice Report that highlighted Aboriginal health inequality and the need for Aboriginal and non-Aboriginal partnership, 6 players on all sides of politics, together with Aboriginal and non-Aboriginal health peak bodies, signed a Statement of Intent to close the life expectancy gap by 2030 and provide the necessary primary healthcare to meet the goal by 2018. 7 Diabetes is the sixth major cause of death in Australia, costing more than $1 billion each year in direct healthcare costs. 8,9 Diabetes was reported by 6% of Aboriginal Australians in 2004/05. After adjusting for age, they were 3-4 times more likely than other Australians to report having diabetes or high sugar levels. 10 Culture and identity are central to Aboriginal perceptions of health and ill health, which relate to "not just the physical wellbeing of the individual, but the social, emotional and cultural well-being of the community". This is a 'whole-of-life' view and includes the cyclical concept of lifedeath-life. 11 While Aboriginal perceptions of identity may vary between urban and remote contexts, and between different communities,
International journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua, 2015
This article describes the characteristics and reviews the methodological quality of interventions designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA. A total of 17 electronic databases and 13 websites for the period of 2002-13. Studies were included if they evaluated an intervention strategy designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, the USA or Canada. Information on the characteristics and methodological quality of included studies was extracted using standardized assessment tools. Sixteen published evaluations of interventions to improve cultural competency in health care for Indigenous peoples were identified: 11 for Indigenous peoples of the USA and 5 for Indigenous Australians. The main types of intervention strategies were education and training of the health workforce, culturally specific health programs and recruitment of an Indigenous healt...
2020
In Australia, an evidence gap exists for governments and policymakers about what it means when the cultures of Aboriginal and Torres Strait Islander people are included in public policies. Specifically, when the cultures of Indigenous Australians have been incorporated in a public health policy like the Australian Government's National Aboriginal and Torres Strait Islander Health Plan 2013-2023 (Health Plan), how do policymakers implement - enable, embed, and enact - cultures? More disturbing is the non-recognition of Indigenous culture's innate relationship to the knowledges held by Indigenous Australians. In recognition of the importance of Indigenous cultures to the health and wellbeing of Indigenous Australians, the centrality of culture in the Health Plan represents the first national Indigenous public policy that reflects its relevance. This research protocol describes a public policy qualitative research study that aims to address this evidence gap by using the He...
BMJ Open, 2023
Introduction The health and well-being of Aboriginal Australians is inextricably linked to culture and Country. Our study challenges deficit approaches to health inequities by seeking to examine how cultural connection, practice and resilience among Aboriginal peoples through participation in 'cultural camps' held on sites of cultural significance promotes health and well-being. Methods and analysis The study will be undertaken in close collaboration and under the governance of traditional cultural knowledge holders from Yuwaalaraay, Gamilaraay and Yuin nation groups in New South Wales, Australia. Three cultural camps will be facilitated, where participants (n=105) will engage in activities that foster a connection to culture and cultural landscapes. A survey assessing connection to culture, access to cultural resources, resilience, self-rated health and quality of life will be administered to participants pre-camp and post-camp participation, and to a comparative group of Aboriginal adults who do not attend the camp (n=105). Twenty participants at each camp (n=60) will be invited to participate in a yarning circle to explore cultural health, well-being and resilience. Quantitative analysis will use independent samples' t-tests or χ 2 analyses to compare camp and non-camp groups, and linear regression models to determine the impact of camp attendance. Qualitative analysis will apply inductive coding to data, which will be used to identify connections between coded concepts across the whole data set, and explore phenomenological aspects. Results will be used to collaboratively develop a 'Model of Cultural Health' that will be refined through a Delphi process with experts, stakeholders and policymakers. Ethics and dissemination The study has ethics approval from the Aboriginal Health and Medical Research Council (#1851/21). Findings will be disseminated through a combination of peer-reviewed articles, media communication, policy briefs, presentations and summary documents to stakeholders.
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists, 2018
An expert reference group met on four occasions to consider ways forward in terms of Indigenous mental health. This paper summarises the discussion and recommendations. While the negative effects of colonisation and trans-generational trauma continue, we propose renewed emphasis on improving access, cultural orientation and trauma-informed care, and a focus on the needs of young Indigenous Australians.
Australian Psychologist, 2016
It has been acknowledged that the mental health of Aboriginal and Torres Strait Islander people has been 'bedeviled' by the inappropriate application of non-Indigenous models of mental health. To enhance Indigenous health and wellbeing it is necessary for non-Indigenous practitioners to find a culturally safe way to enter the negotiated space of cross-cultural mental health. This will be facilitated through understanding both the points of similarity and divergence in perspectives of mental health across cultures. The current study aimed to explore urban Aboriginal and Torres Strait Islander's understandings of mental health using a Social Emotional Wellbeing and Cognitive Behavioural framework. Method: A qualitative research project was conducted with a sample of 19 Australian Aboriginal and Torres Strait Islanders people. Data was collected via individual semistructured interviews and focus groups. Thematic analysis was conducted to identify themes within the data. Results: Qualitative: Four themes emerged as reflecting health and wellbeingcoping skills, knowledge, social support, and connectedness. The theme of connectedness to country, family and kinship, cultural knowledge and social networks emerged as reflecting a unique contribution to Indigenous health and wellbeing. However, the themes of coping skills, knowledge and social support shared crosscultural meaning. In particular, coping skills identified in the behavioural, emotional and cognitive domains shared many cross-culturally applicable avenues for intervention. Conclusions: Therapeutic interventions in these domains are already well established within cognitive behaviour therapies. Cross-cultural understandings within these themes offer clinicians a culturally safe avenue for supporting Aboriginal and Torres Strait Islander health and wellbeing. CBT, SEWB and Indigenous health and wellbeing