First Nations Health and Wellbeing - The Lowitja Journal最新文献

{"title":"A First Nations-led community survey of early COVID-19 pandemic experiences in Victoria, Australia","authors":"Katarzyna Wojcik ,&nbsp;Jane Goller ,&nbsp;Joanne Luke ,&nbsp;Lina Gubhaju ,&nbsp;Richard Chenhall ,&nbsp;Graham Gee ,&nbsp;Ngaree Blow ,&nbsp;Lisa Thorpe ,&nbsp;Paul Stewart ,&nbsp;Alister Thorpe","doi":"10.1016/j.fnhli.2025.100060","DOIUrl":"10.1016/j.fnhli.2025.100060","url":null,"abstract":"<div><h3>Purpose</h3><div>During 2020, state and federal government-mandated restrictions and extended lockdowns were implemented in Australia because of the increasing presence of coronavirus disease 2019 (COVID-19). In response to COVID-19 and restrictions, First Nations communities and organisations across Australia developed resources and strategies for support. The state of Victoria experienced the lengthiest lockdowns in Australia. This study aimed to describe the health and sociocultural experiences of First Nations peoples in the Australian state of Victoria during these restrictions.</div></div><div><h3>Methods</h3><div>The Measuring Indigenous Communities’ Response, Resilience and Recovery online survey was developed and implemented by an Indigenous leadership group. This cross-sectional study focused on First Nations communities’ experiences of the pandemic. Descriptive and thematic qualitative analyses were conducted to explore outcomes related to health and social experiences, and cultural and community connectedness.</div></div><div><h3>Main findings</h3><div>A total of 67 people responded between November 2020 and January 2021; 49 (73.1%) were female, with a median age of 47 years, and 54 (81.8%) resided in metropolitan Melbourne. Many respondents (47.5%) reported difficulty accessing general healthcare, mental health and education. First Nations organisations and family members were the primary source of additional support during 2020. Changes in health behaviours – such as alcohol consumption, tobacco use and physical activity – after restrictions were variable. For community connection, respondents reported decreases in seeing family and attending cultural events; however, they reported an increase in the use of technology to connect with community.</div></div><div><h3>Principal conclusions</h3><div>This study provides insights into the experiences of First Nations peoples in Victoria during the 2020 COVID-19 pandemic response, and the types of support and resources accessed. The importance of community connectedness during the COVID-19 pandemic and First Nations-led responses to support community to promote better health outcomes was highlighted in this study.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100060"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When reconciliation overshadows rights: The Métis’ continued fight for health data and recognition","authors":"Alexandra Nychuk (Métis - Manitoba Métis Federation) ,&nbsp;Kiera Kowalski (Métis - Manitoba Métis Federation) ,&nbsp;Chelsea Gabel (Métis - Manitoba Métis Federation) ,&nbsp;Robert Henry (Métis - Métis Nation Saskatchewan)","doi":"10.1016/j.fnhli.2025.100068","DOIUrl":"10.1016/j.fnhli.2025.100068","url":null,"abstract":"<div><div>In 2021, the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) Act received royal assent in Canada, further affirming inherent rights for Indigenous peoples (First Nations, Inuit and Métis). Despite this and a constitutional recognition of Aboriginal rights in 1982, the Métis have yet to have their right to health recognised. The prioritisation of pan-Indigenous approaches to addressing inequities in Canada neglects to recognise the collective rights (exercised through a governing body, nation, tribal community, etc.) that diversifies Indigenous rights from other human rights. Métis critically need accurate health data that are conducted using distinctions-based approaches, as they remain stuck in data dependency. However, a considerable barrier to Métis data collection is that Indigenous health research funding in Canada predominantly favours pan-Indigenous approaches, rendering the Métis insignificant in their fight for health recognition.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Raising the voices of young people in remote Aboriginal communities in Australia to identify place-based support needs: The Bigiswun Kid Project","authors":"Lauren J. Rice ,&nbsp;Emily Carter ,&nbsp;Emma Bear ,&nbsp;Mudge Bedford ,&nbsp;Cheyenne Carter ,&nbsp;Jadnah Davies ,&nbsp;Nikkita Rice ,&nbsp;Sue Thomas ,&nbsp;Fergus Wells ,&nbsp;Elizabeth J. Elliott","doi":"10.1016/j.fnhli.2025.100084","DOIUrl":"10.1016/j.fnhli.2025.100084","url":null,"abstract":"<div><h3>Purpose</h3><div>Adolescence is a crucial developmental period that is distinct from childhood and adulthood. There is a global push for adolescent-specific services informed by young people; such services are crucial for Aboriginal and Torres Strait Islander peoples because adolescents make up one-third of the population. The authors of this study worked with young people and their families to: identify the support that young people need to thrive in remote Aboriginal communities; report how young people and their parents would like this support to be delivered; and describe what was learned from piloting support during the research project.</div></div><div><h3>Methods</h3><div>Ninety-four (83%) of all young people born in 2002–03 (aged 16 to 19 years) who were living in the Fitzroy Valley at the time and 101 (89%) of their parents were interviewed. Using an Aboriginal participatory action approach, the authors worked with young people and local Aboriginal leaders to pilot some support.</div></div><div><h3>Main findings</h3><div>The seven most common supports that were requested were: opportunities to participate in cultural and on-Country activities, organised sports, community-based youth hubs/safe places, public transport, child development workshops, supported work programs, and supported tertiary education. Parents and young people wanted individual communities re-empowered to design and lead this support.</div></div><div><h3>Principal conclusions</h3><div>The learnings and recommendations described in this paper can be used by local services to enhance existing and develop new support that enables young people to successfully transition into adulthood. This approach could identify and pilot support needs in communities elsewhere.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring best practices that integrate environmental health and primary healthcare in Indigenous populations: A scoping review","authors":"Jayden Wells ,&nbsp;Veronica Matthews ,&nbsp;Amal Chakraborty","doi":"10.1016/j.fnhli.2025.100071","DOIUrl":"10.1016/j.fnhli.2025.100071","url":null,"abstract":"<div><h3>Purpose</h3><div>Country and the environment are essential components of Aboriginal and Torres Strait Islander wellbeing. Colonisation disrupted these essential connections, damaging important reciprocal beneficial relationships that kept Country and community well. As a result, Indigenous populations exhibit poorer health outcomes compared with non-Indigenous Australians, with the life expectancy of Indigenous Australians being 74 years compared with 84 years in the general population. It is reported that 20 to 30 per cent of Indigenous disease burden can be attributed to environmental factors; however, historically, there has been little coordination between the environmental and primary healthcare sectors in Australia. The National Aboriginal Community Controlled Health Organisation (NACCHO) has called for increased collaboration between environmental initiatives and primary healthcare to address various health disparities present within Indigenous Australians. This scoping review aimed to identify and analyse best practices that integrate environmental health initiatives and primary healthcare within Indigenous populations.</div></div><div><h3>Methods</h3><div>Standard scoping review methodology was employed in accordance with PRISMA-ScR Joannah Briggs Institute guidelines. Databases that were searched included CINAHL, Scopus, MEDLINE and Embase, as well as grey literature, between 2004–24. Inclusion criteria focused on studies involving international Indigenous populations, environmental health factors and primary healthcare integration, with two primary reviewers and a third for resolving conflicts.</div></div><div><h3>Main findings</h3><div>A total of 32 papers, primarily from Australia, were included in the final review. Regarding environmental determinants, there was a strong focus on housing condition, water quality and Indigenous land management. Various integrated programs demonstrated significant health improvements, such as reduced prevalence of infectious disease, enhanced cardiovascular health and better mental health outcomes. The concept of Indigenous 'caring for Country' emerged as a central theme, demonstrating the benefits of a unified approach to healthcare.</div></div><div><h3>Principal conclusions</h3><div>These findings demonstrate the value of implementing connections between environmental and primary healthcare services in improving Indigenous health. Factors leading to program success included community participation, Indigenous leadership and targeted, place-based interventions. However, there is a general lack of published evidence that sustainably integrates both environmental health and primary care. The limited number of examples demonstrated positive health outcomes, indicating the need for more community-led and Country-centred initiatives within primary care.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100071"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing health system accountability: A scoping review of cultural security and Indigenous health","authors":"Brianna Poirier (Canadian),&nbsp;Madison Cachagee (Omushkego Mushkegowuk),&nbsp;Lisa Jamieson (New Zealander)","doi":"10.1016/j.fnhli.2025.100073","DOIUrl":"10.1016/j.fnhli.2025.100073","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite the countless frameworks emphasising the need for culturally safe provision of care, systemic racism persists and, in some cases, the gap between Indigenous and non-Indigenous health has widened. Cultural security is differentiated from cultural safety due to its demand of system-level changes that inform provision of care. Confusion with a myriad of other cultural terminologies has diluted the nuances between actions required to create culturally secure environments. Therefore, this scoping review was undertaken to explore existing evidence that contributes to the understandings and applications of cultural security for global Indigenous peoples across all health contexts, while recognising the potential overlap with systems-level definitions of cultural safety and the opportunity to clarify the distinctive contributions of cultural security.</div></div><div><h3>Methods</h3><div>Two reviewers screened records from PubMed and then adapted for Scopus, Embase, Web of Science, ProQuest and Australian Indigenous HealthInfoNet. Inclusion in this review was not restricted by geographical location or language. Underscored by principles of critical realism and decolonising methodologies, principles related to the implementation and understanding of cultural security were extracted from each of the included articles and synthesised into common categories.</div></div><div><h3>Main findings</h3><div>The systematic search identified 1,809 unique records, with 28 fulfilling the inclusion criteria. Twenty-four of the articles were related to Aboriginal and Torres Strait Islander health in Australia and four articles discussed Indigenous health globally. Evidence related to the understanding and implementation of cultural security was synthesised into 12 shared principles of cultural security. These principles focused on the importance of cultural identity, worldviews and values in healing, as well as the need for system level commitments and pathways of accountability for the creation of culturally secure environments.</div></div><div><h3>Principal conclusions</h3><div>Commitment to culturally secure provision of care at both an institutional and individual level is both an ethical and moral necessity for all healthcare providers. The balance of policy changes that incorporates space for living Indigenous cultures to ebb and flow necessitates a commitment to daily conversations, practices of reflexivity, and evaluation processes that measure service effectiveness for the Indigenous communities they serve.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100073"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Victorian Aboriginal services co-creating knowledge about healing and recovery for Aboriginal and Torres Strait Islander survivors of child sexual abuse: A study protocol","authors":"Graham Gee ,&nbsp;Carlina Black ,&nbsp;Stella Mulder ,&nbsp;Stephanie J. Brown ,&nbsp;Jordan Gibbs ,&nbsp;Laura Biggs ,&nbsp;Helen Kennedy ,&nbsp;Helen Milroy","doi":"10.1016/j.fnhli.2025.100076","DOIUrl":"10.1016/j.fnhli.2025.100076","url":null,"abstract":"<div><div>Child sexual abuse is a human rights and public health issue with harmful impacts on individuals, families and communities of all nations and cultures. There is a lack of research on healing and recovery from child sexual abuse for Aboriginal and Torres Strait Islander individuals, families and communities. This protocol describes a program of research that was co-designed with practitioners and senior staff from six Aboriginal partner services dedicated to supporting Aboriginal and Torres Strait Islander survivors of child sexual abuse in the Australian state of Victoria. This multi-method study is grounded in Indigenous research methodologies and methods of data generation, in addition to complementary Western methodologies and methods of data analysis. The overarching aim of the project that this program of research is situated within is to better understand and respond to the experiences and healing needs of Aboriginal and Torres Strait Islander peoples with lived experience of child sexual abuse.</div><div>The specific aims for the first phase of research outlined in this protocol are to: (1) strengthen the wellbeing and capacity of the workforce dedicated to supporting Aboriginal and Torres Strait Islander survivors of child sexual abuse; and (2) build a Victorian workforce understanding of the experiences and processes of healing in relation to child sexual abuse from Aboriginal and Torres Strait Islander perspectives. The protocol outlines three related research activities, which make up this first phase of the study. The first activity involves cultural wellbeing and yarning gatherings for staff of the partner services to yarn about healing from child sexual abuse. This research activity utilises yarning and a grounded theory approach. The second activity involves an evaluation of a community of practice for staff, utilising yarning and reflexive thematic analysis. The third activity is a scoping review that investigates Indigenous peoples’ experiences of healing from child sexual abuse and utilises thematic analysis. This co-designed program of research focuses on supporting practitioners and services dedicated to survivors of child sexual abuse through the development of new knowledge inclusive of practice wisdom and privileging Aboriginal and Torres Strait Islander knowledges.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100076"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aboriginal and Torres Strait Islander researchers’ voices on the rights to sovereignty and self-determination in the field of health and medical research","authors":"Felicity Collis (Gomeroi) ,&nbsp;Kade Booth ,&nbsp;Jamie Bryant ,&nbsp;Catherine Chamberlain (Palawa) ,&nbsp;Jaquelyne T. Hughes (Wagadagam) ,&nbsp;Kalinda Griffiths (Yawuru) ,&nbsp;Mark Wenitong (Kabi Kabi) ,&nbsp;Peter O’Mara (Wiradjuri) ,&nbsp;Alex Brown (Yuin) ,&nbsp;Sandra Eades (Noongar) ,&nbsp;Kelvin Kong (Worimi) ,&nbsp;Michelle Kennedy (Wiradjuri)","doi":"10.1016/j.fnhli.2025.100094","DOIUrl":"10.1016/j.fnhli.2025.100094","url":null,"abstract":"<div><div>Due to exclusionary policies, Aboriginal and Torres Strait Islander peoples have only been invited to be part of academic institutions in Australia for the past 65 years. Previous research has highlighted the negative and harmful experiences of Aboriginal and Torres Strait Islander academics and students. Within health and medical research, there are a growing number of Aboriginal and Torres Strait Islander researchers; however, less is known about the nuanced and complex challenges faced when they are required to operate within research institutions and universities. This study aimed to examine the experiences and perspectives of Aboriginal and Torres Strait Islander researchers working in the field of health and medical research. Sixteen Aboriginal and Torres Strait Islander knowledge holders (researchers) shared their wisdom and stories, utilising a qualitative yarning method. One main theme emerged throughout the study: coloniality is entrenched, reinforced and upheld by institutional systems and structures in the field of health and medical research. Knowledge holder highlighted the ongoing burden, harm and violence inflicted within the field of health and medical research. Whilst there have been systems and ethical processes built to safeguard communities, these often add additional burden for the Aboriginal and Torres Strait Islander researchers enacting them. Senior knowledge holders highlighted their attempts to change colonial practices within institutions by seeking higher positions of influence to effect meaningful reform, which often resulted in further entrenched harm and burnout. The silencing and erasure of Indigenous knowledges continues to occur when institutions employ performative progressivism. Despite this harm and colonial violence, the resilience and perseverance of Aboriginal and Torres Strait Islander peoples persist. The collective strength of Aboriginal and Torres Strait Islander peoples is paramount to resisting institutional coloniality and will remain steadfast despite colonial agendas. Research institutions and universities must continue to progress through truth-telling that ensures that Aboriginal and Torres Strait Islander peoples’ sovereignty, knowledges and knowledge systems are truly upheld in the field of health and medical research.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100094"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Peoples’ cultural medicines: A review of Australian health policies using an Indigenous critical discourse analysis approach","authors":"Alana Gall (Pakana, Truwulway) ,&nbsp;Mike Stephens ,&nbsp;Zyana Gall (Pakana, Truwulway) ,&nbsp;Danielle Armour (Kamilaroi) ,&nbsp;Nicole Hewlett (Melukerdee, Palawa) ,&nbsp;Michelle Kennedy (Wiradjuri) ,&nbsp;Theresa Sainty (Pakana, Truwulway) ,&nbsp;Allyra Hulme (Wiradjuri) ,&nbsp;Jon Wardle ,&nbsp;Megan Campbell ,&nbsp;Andrew T. Gall (Pakana, Truwulway) ,&nbsp;Amie Furlong ,&nbsp;Kate Anderson","doi":"10.1016/j.fnhli.2025.100046","DOIUrl":"10.1016/j.fnhli.2025.100046","url":null,"abstract":"<div><h3>Purpose</h3><div>First Peoples in Australia tend to have shared holistic understandings of health and wellbeing that emphasise strong interconnections among family, community, culture and Country. Central to this holistic health framework is First Peoples’ cultural medicines, which most First Peoples use or want to use, and have been used for millennia to heal the bodies, minds and spirits of First Peoples. This review aimed to explore and document the inclusion and representation of cultural medicines across national level policies and practice guidelines for health professionals. These policies intend to support effective and appropriate healthcare for all Australians, including First Peoples.</div></div><div><h3>Methods</h3><div>Australian national health policies that guide the practice of Australian Health Practitioner Regulation Agency registered health professionals and Aboriginal and Torres Strait Islander health workers/Indigenous liaison officers were systematically reviewed to explore their representation of cultural medicines in these policies. The review was informed by Indigenous critical discourse analysis that was modified to suit the review context. National level health policies from March to June 2023 were mapped and 52 policies eligible for inclusion were identified. Policies were downloaded and imported into NVivo for analysis. NVivo text search queries were conducted and nine policies were found to include any content about cultural medicines.</div></div><div><h3>Main findings</h3><div>Three overarching themes were found: 1) Absence of national leadership; 2) Disproportionate onus placed on Aboriginal and/or Torres Strait Islander health practitioners; and 3) Lack of detail and actionable directives. There was a distinct lack of representation of cultural medicines in national health policies, with most of these policies not providing any clear guidance for health professionals. The responsibility was too heavily placed on First Peoples health professionals to lead the healthcare related to cultural medicines.</div></div><div><h3>Principal conclusions</h3><div>The significant lack of national leadership and actionable directives around cultural medicines is concerning. To uphold cultural safety and the rights of Australia’s First Peoples, it is critical to have clear policy guidance, resources and training that support all Australian health professionals to engage with cultural medicines and see it as part of their responsibility.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100046"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empirical assessment of cultural safety within Australian hospitals highlights the impact of access to Aboriginal hospital liaison officers on the experiences of Aboriginal patients","authors":"Elissa Elvidge ,&nbsp;Steven L. Taylor ,&nbsp;Kiara Harvey ,&nbsp;Yeena Thompson ,&nbsp;Jessica Armao ,&nbsp;Geraint B. Rogers ,&nbsp;Amy Creighton ,&nbsp;Yin Paradies","doi":"10.1016/j.fnhli.2025.100061","DOIUrl":"10.1016/j.fnhli.2025.100061","url":null,"abstract":"<div><h3>Purpose</h3><div>Ensuring access to hospital services that are culturally safe is imperative for improving Aboriginal and Torres Strait Islander health outcomes. Addressing failings within existing services relies on the ability to prioritise areas for improvement in a methodologically robust manner that reflects the experiences of Indigenous service users. The construct and content validity of the Cultural Safety Survey, a mixed-methods questionnaire-based tool that captures the lived experiences of First Nations peoples attending hospital, was previously established. This study aimed to identify hospital and participant characteristics associated with positive or negative experiences of care.</div></div><div><h3>Methods</h3><div>Study sites included 49 hospitals in New South Wales, either through direct engagement with the hospital or opportunistic participant recruitment. A total of 413 participants took part in the study; 307 completed the whole survey and 298 of them had complete hospital and demographic data for analysis. Multivariable ordinal logistic regression was used to identify contributors to composite and domain-specific cultural safety scores. Assessed variables included respondent age, gender, distance travelled, attendance capacity (patient or visitor), hospital size, remoteness and socioeconomic status of location. Additional analysis assessing reported interaction with an Aboriginal hospital liaison officer (AHLO) on cultural safety scores was also performed.</div></div><div><h3>Main findings</h3><div>Of 413 participants, 298 provided complete demographic and hospital data, and confirmed informed consent. Responses related to 49 separate hospitals in New South Wales. Participant age and level of interaction with an AHLO showed a consistently positive association with cultural safety score. A unit increase in age was associated with 51.3% increased odds of a higher overall cultural safety score (<em>P</em> = .0012). Similarly, each unit increase in AHLO interaction was associated with 89.3% greater likelihood of a higher cultural safety score (<em>P</em> = .0031). Other variables – including higher socioeconomic advantage, female gender, and a shorter distance travelled – were positively associated with specific cultural safety domains. Respondent comments captured in the free text component of the questionnaire were consistent with quantitative findings.</div></div><div><h3>Principal conclusions</h3><div>The findings highlight the importance of access to an AHLO when visiting hospital. More generally, the ability to quantify the performance of hospital services based on the experiences of Indigenous end-users, and to identify factors that contribute to the nature of those interactions, provides a potential guide for impactful service reform.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100061"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communities getting things done: Māori community leadership during the COVID-19 pandemic","authors":"Jodie Robertson,&nbsp;Tasha Burton,&nbsp;Anna Rolleston","doi":"10.1016/j.fnhli.2025.100080","DOIUrl":"10.1016/j.fnhli.2025.100080","url":null,"abstract":"<div><h3>Purpose</h3><div>In 2023, researchers from Tauranga, Aotearoa New Zealand (hereinafter referred to as Aotearoa) carried out a study to explore the unique strengths of Māori (Indigenous people of Aotearoa) services in addressing the needs of their communities during the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>Two case studies of Māori providers in the North Island’s Bay of Plenty region were undertaken. A qualitative <em>kaupapa</em> Māori (philosophical doctrine) approach was utilised across three methods to inform the research: 1) review of community materials, 2) <em>whakawhiti kōrero</em> (reciprocal discussions), and 3) <em>whānau</em> (family) narratives. The research included 34 participants, sourced from three groups: <em>kaiwhakahaere</em> (leadership), <em>kaimahi</em> (workforce), and <em>whānau</em>.</div></div><div><h3>Main findings</h3><div>Community-led pandemic responses within Māori communities included a drive for coordinated, localised and Indigenous leadership, and a need for urgent community-led action that interrupted the trajectory of Crown-determined processes. Successful health interventions leveraged local knowledge, <em>whakapapa</em> (genealogical) connections, and services through community-led action. This required levels of leadership and self-determination that cannot be replicated through Crown-led, Crown-determined responses to healthcare. This research provides an evidence-based framework consisting of 23 strategies to increase equitable health outcomes for Indigenous and other marginalised and/or isolated communities.</div></div><div><h3>Principal conclusions</h3><div>This research underscores the importance of enabling communities to lead through their own models of leadership and community development, recognising that they possess the intimate knowledge and understanding necessary to effectively respond to the specific needs of their people at <em>whānau</em>, <em>hāpori</em> (community), <em>hapū</em> and <em>iwi</em> (tribal) levels. Six generations of evidence show that the health system is not working equally for all parts of Aotearoa. It is time for an urgent response to those everyday health issues that have become an area of pandemic need. This research concluded to seriously consider the evidence that Māori communities, Māori providers and Māori clinicians led the way during the pandemic. As a nation, if we want to genuinely change the trajectory of Māori health outcomes and health outcomes for all, we need to utilise the evidence that is before us in terms of recognising the value added in having Indigenous, community-led solutions.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}