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

{"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}

{"title":"A methodological approach to generate local solutions that promote Aboriginal and Torres Strait Islander social and emotional wellbeing on Kaurna Country, Australia","authors":"Anna Dawson ,&nbsp;Eugene Warrior (Kokatha/Narungga) ,&nbsp;Odette Pearson (Kuku Yalanji/Torres Strait Islander) ,&nbsp;Mark Boyd ,&nbsp;Judith Dwyer ,&nbsp;Kim Morey (Anmatyerre/Eastern Arrernte) ,&nbsp;Tina Brodie (Yawarrawarrka/Yandruwandha) ,&nbsp;Kurt Towers (Wiradjuri) ,&nbsp;Sonia Waters (descendent of three generations of Stolen Generations women, with connection to Ooldea on the Far West Coast of South Australia) ,&nbsp;Cynthia Avila ,&nbsp;Courtney Hammond (Eastern Arrernte/Tanganekald) ,&nbsp;Katherine Lake ,&nbsp;Uncle Frank Lampard (Ngarrindjeri/Kaurna) ,&nbsp;Uncle Frank Wanganeen (Kaurna/Narungga) ,&nbsp;Olive Bennell (Wiradjuri) ,&nbsp;Darrien Bromley (Narungga/Adnyamathanha) ,&nbsp;Toni Shearing (Narungga/Kokatha) ,&nbsp;Nathan Rigney (Ngarrindjeri) ,&nbsp;Schania Czygan (Kuku Yalanji) ,&nbsp;Nikki Clinch (Badimia/Yamatji) ,&nbsp;Alex Brown (Yuin)","doi":"10.1016/j.fnhli.2025.100043","DOIUrl":"10.1016/j.fnhli.2025.100043","url":null,"abstract":"<div><div>Aboriginal and Torres Strait Islander communities are diverse, strong and faced with adverse social circumstances and unacceptable health and wellbeing outcomes wrought by colonisation. The need for strengths-based initiatives that tailor services according to local knowledges is well accepted, yet few studies have evaluated self-determined strategies to redress the social determinants of health. We describe a research approach where principles of Indigenous methodology guide application of implementation science methods to generate, implement and evaluate local solutions from the perspectives of Aboriginal and Torres Strait Islander peoples. Partnerships with local communities and service organisations are paramount. The co-design phase collected critical insights regarding community needs, challenges and service gaps, and identified shortfalls in local strategic policy. A co-designed theory of systems change articulates mechanisms to strengthen policy, optimise the health and social service system, and empower and connect communities. A developmental approach to the implementation and evaluation of individual, community and service system initiatives will generate new evidence regarding efforts to tackle social factors and promote wellbeing.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100043"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aboriginal deaths in custody in Western Australian prisons: The importance of implementing cultural safety and human rights","authors":"Ee Pin Chang ,&nbsp;Hannah McGlade ,&nbsp;Pat Dudgeon ,&nbsp;Jocelyn Jones","doi":"10.1016/j.fnhli.2025.100088","DOIUrl":"10.1016/j.fnhli.2025.100088","url":null,"abstract":"<div><h3>Purpose</h3><div>Aboriginal peoples’ ways of knowing, being and doing have sustained the longest continuing culture in the world of over 60,000 years. The impacts of colonisation and government policies have contributed to systemic discrimination and marginalisation. Aboriginal peoples continue to experience disadvantages across health, housing, education, employment and in the criminal justice systems. The overrepresentation of Aboriginal adults in the criminal justice system is a serious human rights issue highlighted in numerous important government reports and inquiries. Over 30 years since the Royal Commission into Aboriginal deaths in Custody (RCIADIC), the overrepresentation of Aboriginal peoples in the criminal justice system remains a national concern, and most of the recommendations have not been implemented. Western Australia (WA) records the highest incarceration rate in Australia. The severe overrepresentation of Aboriginal peoples remains a priority in the National Agreement on Closing the Gap.</div></div><div><h3>Methods</h3><div>The scope of this article is to provide an overview of the nature and adequacy of culturally appropriate health services within WA prisons based on coroner findings on Aboriginal deaths in custody between 2019 to 2023.</div></div><div><h3>Main findings</h3><div>Three of eight coronial inquests into Aboriginal suicide deaths in custody reviewed reported the sub-standard and unacceptable quality of supervision, treatment and care. The lack of access to culturally safe health services in prisons contravenes the recommendations of the RCIADIC.</div></div><div><h3>Principal conclusions</h3><div>We call for implementation of recommendations from Australian government inquiries – RCIADIC, ALRC Pathways to Justice report – and our government to uphold international human rights obligations especially the Optional Protocol to the Convention Against Torture.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100088"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361112","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":"Erratum to Reproductive injustice in action: The impact of the Supreme Court’s Dobbs decision on Indigenous and minority women [First Nations Health and Wellbeing - The Lowitja Journal 3 (2025) 100042]","authors":"Margo Hill ,&nbsp;Frank Houghton ,&nbsp;Mary Ann Keogh Hoss","doi":"10.1016/j.fnhli.2025.100093","DOIUrl":"10.1016/j.fnhli.2025.100093","url":null,"abstract":"","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100093"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157288","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 Nations perspectives about youth pregnancy and parenthood in Western Sydney, Australia: A qualitative study","authors":"Simon Graham (Narungga) ,&nbsp;Kacey Martin (Ngāti Pikiao) ,&nbsp;Kristy Gardner (Kamilaroi) ,&nbsp;Mitchell Beadman (Yuin and Wonnarua) ,&nbsp;Michael F. Doyle (Bardi) ,&nbsp;Reuben Bolt (Yuin, Wandandian, Ngarigo) ,&nbsp;Dean Murphy ,&nbsp;Stephen Bell ,&nbsp;Carla Treloar ,&nbsp;Annette J. Browne ,&nbsp;Peter Aggleton ,&nbsp;Karen Beetson (Mandandanji) ,&nbsp;Megan Brooks ,&nbsp;Jessica R. Botfield ,&nbsp;Ben Davis ,&nbsp;Jessica Wilms (Wiradjuri) ,&nbsp;Bronwyn Leece ,&nbsp;Linda Stanbury ,&nbsp;Joanne Bryant","doi":"10.1016/j.fnhli.2025.100047","DOIUrl":"10.1016/j.fnhli.2025.100047","url":null,"abstract":"<div><h3>Purpose</h3><div>Significant improvements have been made in Aboriginal and Torres Strait Islander peoples’ (First Nations) maternal and perinatal outcomes over the past decade, such as decreasing rates of smoking and preterm birth and increasing birthweights. In Australia, higher rates of adolescent pregnancy are reported among First Nations compared with non-First Nations people. Having a baby during adolescence (youth pregnancy) increases the risk of poorer maternal and perinatal outcomes, including social outcomes such as poverty and educational attainment. This study examined First Nations peoples’ perspectives about youth pregnancy and parenthood in Western Sydney, Australia.</div></div><div><h3>Methods</h3><div>Sixty-eight First Nations people aged ≥16 years living in Western Sydney, Australia were interviewed in 2019–20. Interview data were analysed using thematic analysis.</div></div><div><h3>Main findings</h3><div>Approximately half of the participants were aged ≥18 years. Most participants lived with family and around half were high school students. Four themes relating to youth pregnancy and parenthood were identified: 1) youth pregnancy was normalised (e.g. ‘There’s always some young person in [the] community pregnant, if not several… it’s celebrated as well. It’s not so much of a negative thing’); 2) a desire to avoid youth pregnancy (e.g. ‘I think young people try and avoid pregnancy because they don’t wanna be a teen mum’); 3) gendered experiences of youth pregnancy and parenthood (e.g. ‘I don’t think a teenage boy would have like time like for a baby’); and 4) perspectives of caring responsibilities within families (e.g. ‘I feel like within Aboriginal communities, it’s always seen as the oldest kid has to kind of help out the parent’).</div></div><div><h3>Principal conclusions</h3><div>Although youth parenthood was acceptable in communities, most participants wanted young people to avoid pregnancy and parenthood. There was a clear community approach to raising children, especially from the oldest children helping out with child raising.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100047"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of trauma-based therapies for Aboriginal and non-Aboriginal children and adolescents in out-of-home care","authors":"Debbie Haynes ,&nbsp;Sean A. Halpin ,&nbsp;Laurel Williams ,&nbsp;Bronwyn Chambers ,&nbsp;Frances Heritage Martin","doi":"10.1016/j.fnhli.2025.100070","DOIUrl":"10.1016/j.fnhli.2025.100070","url":null,"abstract":"<div><h3>Purpose</h3><div>Aboriginal and Torres Strait Islander children are more likely to enter out-of-home care (OOHC) in New South Wales (NSW), Australia, than non-Aboriginal children. In response to recommendations (<span><span>Tune 2015</span></span>) that asserted the need for culturally responsive programs designed to meet the cultural needs of children and adolescents in OOHC, the NSW government initiated a pilot project across two regions in NSW, Australia. The LINKS Trauma Healing Service was established to provide multidisciplinary services to children and adolescents in OOHC. The service has a particular focus on culturally responsive effectiveness of therapies delivered to Aboriginal and Torres Strait Islander children, adolescents and their families. Three earlier evaluations of the LINKS program have highlighted positive trends in outcomes for children and their families in NSW OOHC. This study aimed to further investigate the effectiveness of culturally responsive therapies for both Aboriginal and Torres Strait Islander and non-Aboriginal children and adolescents in OOHC in NSW, Australia.</div></div><div><h3>Methods</h3><div>An analysis was conducted on the LINKS data collected from 144 children and adolescents (70 Aboriginal/Torres Strait Islander children and 74 non-Aboriginal children) aged 3 to 16 years. Data were analysed using mixed measures analysis of variance (ANOVA), to investigate effectiveness of culturally adapted trauma therapies for Aboriginal and Torres Strait Islander children participating in the LINKS program. Data were analysed in unison with outcomes for non-Aboriginal children and young people.</div></div><div><h3>Main findings</h3><div>Data supported statistically significant reductions in difficulties and trauma symptoms for both Aboriginal/Torres Strait Islander and non-Aboriginal children and adolescents. Eye movement desensitisation and reprocessing and parent–child interaction therapy treatments were found to be most beneficial in reducing trauma symptoms overall. The results further indicate no significant differences in outcomes between Aboriginal and non-Aboriginal children, with comparable rates of improvement for both groups.</div></div><div><h3>Principal conclusions</h3><div>Trauma treatments utilised within the LINKS service show effectiveness in reducing difficulties and trauma symptoms for Aboriginal/Torres Strait Islander and non-Aboriginal children/adolescents in OOHC. This study provides some support for embedding culturally responsive approaches into mental health services delivered to children/adolescents in OOHC. It highlights the necessity for clinicians to align service delivery with the cultural values and needs of communities. Future research should address clinician cultural parity and incorporate control groups to strengthen the evidence base.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288776","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":"The Māori Health Data Governance Model: A planning and protocol checklist","authors":"Lisa Kremer (Kāi Tahu, Kāti Māmoe, Waitaha) ,&nbsp;Sue Crengle (Kāi Tahu, Kāti Māmoe, Waitaha) ,&nbsp;Karen Bartholomew (Pākehā) ,&nbsp;Tahu Kukutai (Ngāti Tiipa, Ngāti Māhanga, Ngāti Kinohaku, Te Aupōuri)","doi":"10.1016/j.fnhli.2025.100074","DOIUrl":"10.1016/j.fnhli.2025.100074","url":null,"abstract":"<div><h3>Purpose</h3><div>Māori health data (MHD) governance is a critical enabler of achieving health equity for Māori. The Māori Data Governance Model (the Model) provides a framework for all stages of Māori data handling but has yet to be meaningfully implemented within health settings. This study aimed to meet the need for health-specific guidance by adapting the Model to create an MHD governance checklist. This checklist can be used by health researchers and agencies to develop and embed their own MHD governance protocol (e.g. embed within study protocol).</div></div><div><h3>Methods</h3><div>Eight <em>Pou</em> were adapted from the Model and further questions were generated from The Health Services and Outcomes Kaupapa Inquiry WAI2575, National Ethics Advisory Committee guideline and the CARE (collective benefit, authority to control, responsibility, ethics) principles.</div></div><div><h3>Main findings</h3><div>Every effort should be made to include Māori participation in the health research or agency that involves any aspect of MHD within all adapted eight data <em>Pou</em>. If this is not possible, an explanation for reasons why and actions for contributing to short-term and long-term solutions for this should be provided.</div></div><div><h3>Principal conclusion</h3><div>The MHD governance planning and protocol checklist provides a <em>te Tiriti o Waitangi</em> approach for health researchers and agencies that can be implemented alongside current ethical practices. The checklist is an actionable tool that can be used to contribute to health equity for Māori.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100074"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653465","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":"Disrupting structural racism: A qualitative study on how to address structural racism and its impacts on the health of First Nations Peoples in Canada","authors":"Krista Stelkia (Syilx/Tlingit from Osoyoos Indian Band) PhD","doi":"10.1016/j.fnhli.2025.100091","DOIUrl":"10.1016/j.fnhli.2025.100091","url":null,"abstract":"<div><div>Structural racism is a critical determinant of Indigenous peoples’ health and wellbeing in Canada. The effects of structural racism are evident in the persistent health inequities faced by First Nations peoples – including disproportionately higher rates of chronic disease, infant mortality and lower life expectancy – compared with other Canadians. Mounting reports and cases of anti-Indigenous racism in the healthcare system have called for more attention to address structural racism. However, there is limited research to date that has explored ways to address structural racism against First Nations peoples. This qualitative study explored how to address structural racism and its impact on the health of First Nations peoples in Canada. Semi-structured interviews with 25 participants were conducted with experts in health, justice/legal, child welfare, education, politics and racism scholarship, and First Nations living with a chronic condition(s). Collected data were analysed using thematic analysis. Five themes emerged on how to address structural racism against First Nations: accountability and consequences; Indigenous authority and representation; anti-racism praxis; education and training; and legislative and policy reform. The findings suggest that addressing an entire ecosystem of structural racism requires a whole-of-society approach that includes strategies targeting individual, policy and structural levels. Ultimately, efforts to address structural racism must be grounded in the fundamental principle of Indigenous peoples’ right to self-determine their own health and wellness journey.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100091"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571113","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":"Indigenous consensus methodology: A bricolage qualitative exploration","authors":"Clinton Schultz (Gomeroi) ,&nbsp;Jemma Collova ,&nbsp;Justyce Pengilly (Gomeroi) ,&nbsp;Roz Walker ,&nbsp;Leilani Darwin (Quandamooka) ,&nbsp;Fiona Shand ,&nbsp;Ee Pin Chang ,&nbsp;Rob McPhee ,&nbsp;Pat Dudgeon (Bardi)","doi":"10.1016/j.fnhli.2025.100097","DOIUrl":"10.1016/j.fnhli.2025.100097","url":null,"abstract":"<div><h3>Purpose</h3><div>Aboriginal and Torres Strait Islander leaders are establishing new research methodologies that are grounded in cultural ways of knowing, being and doing. This paper weaves together Indigenous standpoint theory, yarning and consensus modelling to 1) develop a novel Indigenous consensus methodology and 2) outline the application of this methodology in co-designing an Aboriginal and Torres Strait Islander systems approach to suicide prevention.</div></div><div><h3>Methods</h3><div>Members from an expert advisory group were invited to participate in this study, which involved a co-design phase grounded in an Aboriginal participatory action research approach. The expert advisory group informed the consensus process, which involved the completion of a survey followed by a consensus yarn. The group of 15 yarned until there was consensus regarding items that were important in an Aboriginal and Torres Strait Islander systems approach to suicide prevention.</div></div><div><h3>Main findings and principal conclusions</h3><div>Group consensus was reached on 134 statements. This study demonstrates how the Indigenist consensus methodology, grounded in the principles of bricolage (i.e. deliberate mixing of qualitative methods), offers a transformative lens to designing more culturally responsive ways of strengthening Aboriginal and Torres Strait Islander social and emotional wellbeing and preventing suicide.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100097"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571114","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":"Supporting shared decision-making about cardiovascular disease prevention: Yarning with Aboriginal and Torres Strait Islander health workers/practitioners and consumers","authors":"Judith Parnham ,&nbsp;Shannon McKinn ,&nbsp;David Follent ,&nbsp;Michelle Dickson ,&nbsp;Carissa Bonner","doi":"10.1016/j.fnhli.2025.100098","DOIUrl":"10.1016/j.fnhli.2025.100098","url":null,"abstract":"<div><h3>Purpose</h3><div>Revised Australian guidelines for heart health checks (cardiovascular disease [CVD] risk assessment) provide an opportunity to better support shared decision-making with Aboriginal and Torres Strait Islander communities. Various models and tools have been developed to support shared decision-making, but their usefulness for Aboriginal and Torres Strait Islander communities has not been well explored. Aboriginal and Torres Strait Islander health workers/practitioners already play a key role in health promotion, and could support shared decision-making about the new guidelines. This study explored the experiences of Aboriginal and Torres Strait Islander community members (consumers) and health workers/practitioners (health professionals) on shared decision-making in the context of cardiovascular disease prevention, to inform the development of new guideline resources.</div></div><div><h3>Methods</h3><div>An online yarning workshop with Aboriginal and Torres Strait Islander community members (consumers) was conducted in 2022 to introduce them to shared decision-making resources. This was followed by individual yarning sessions with nine consumers and eight Aboriginal and Torres Strait Islander health workers/practitioners. Interview transcripts were analysed using a yarning process and thematically coded.</div></div><div><h3>Main findings</h3><div>The workshop was used to build rapport and introduce participants to key concepts through shared stories and a demonstration of shared decision-making tools. For consumers, sharing stories about healthcare identified several themes associated with good experiences, including: rapport, continuity, culturally appropriate communication, addressing health literacy needs and different ways of being involved in shared decision-making. Aboriginal and Torres Strait Islander health workers/practitioners explained how they already support shared decision-making about CVD prevention, including pre-screening for CVD risk factors and providing culturally safe healthcare. They also identified opportunities for a greater role in CVD risk assessment for heart health checks, to enable health promotion and education for early prevention.</div></div><div><h3>Principal conclusions</h3><div>Existing tools and models to support shared decision-making about CVD need to reflect a more holistic model of care for Aboriginal and Torres Strait Islander communities, including cultural considerations. Including Aboriginal and Torres Strait Islander health workers/practitioners in cardiovascular disease risk assessment may provide a more culturally safe and appropriate environment in which to enable shared decision-making about heart health checks.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100098"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617492","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}