Indigenous Respiratory Outreach Care: the first 18 months of a specialist respiratory outreach service to rural and remote Indigenous communities in Queensland, Australia

2014 ◽  
Vol 38 (4) ◽  
pp. 447 ◽  
Author(s):  
Linda G. Medlin ◽  
Anne B. Chang ◽  
Kwun Fong ◽  
Rebecca Jackson ◽  
Penny Bishop ◽  
...  
Keyword(s):  
Service Delivery ◽  
Capacity Building ◽  
Aboriginal People ◽  
Unmet Need ◽  
Indigenous Communities ◽  
Clinical Service ◽  
Indigenous Australians ◽  
Culturally Appropriate ◽  
Rural And Remote ◽  
Outreach Service

Objective Respiratory diseases are a leading cause of morbidity and mortality in Indigenous Australians. However, there are limited approaches to specialist respiratory care in rural and remote communities that are culturally appropriate. A specialist Indigenous Respiratory Outreach Care (IROC) program, developed to address this gap, is described. Methods The aim of the present study was to implement, pilot and evaluate multidisciplinary specialist respiratory outreach medical teams in rural and remote Indigenous communities in Queensland, Australia. Sites were identified based on a perception of unmet need, burden of respiratory disease and/or capacity to use the clinical service and capacity building for support offered. Results IROC commenced in March 2011 and, to date, has been implemented in 13 communities servicing a population of approximately 43 000 Indigenous people. Clinical service delivery has been possible through community engagement and capacity building initiatives directed by community protocols. Conclusion IROC is a culturally sensitive and sustainable model for adult and paediatric specialist outreach respiratory services that may be transferrable to Indigenous communities across Queensland and Australia. What is known about this topic? The high rates of respiratory illnesses in Australian Indigenous children have been poorly explored. There is a dearth of research quantifying and qualifying risk from birth and throughout early childhood, and there are virtually no evidence-based evaluations of interventions to prevent and manage disease. Despite data suggesting an excess burden of disease, there has been little attention paid to respiratory health in this population. The limited research that has been done highlights that a ‘one size fits all’ model will not be effective in all communities, and that health service must meet the needs of communities, be culturally appropriate and be accessible to Aboriginal people for it to be effective and sustainable. The ‘common theme’ is that although health services are improving, service delivery needs to adapt to meet the needs of communities; this is not happening quickly enough for many Aboriginal people. What does this paper add? This paper highlights the importance of working with communities in the development and delivery of a culturally appropriate and accessible specialist respiratory service. In addition, this paper acknowledges the importance of recruiting Indigenous staff in the implementation, engagement and delivery of the project. What are the implications for clinicians? This paper provides an outline on how best to deliver a culturally appropriate respiratory outreach service and the role of clinicians, communities and Indigenous staff. This model supports the view that Aboriginal people must be a part of service delivery that is aligned to the ‘holistic concept of health’ for Aboriginal people, thus providing a culturally appropriate service that meets their needs and addresses the health continuum from within culture and community.

scholarly journals Western Australia’s Remote Indigenous Communities: A Case Against Closures and a Call For New Governance

AJIL Unbound ◽  
2015 ◽  
Vol 109 ◽  
pp. 209-214 ◽  
Author(s):  
Asta Hill
Keyword(s):  
Western Australia ◽  
Aboriginal People ◽  
Indigenous Communities ◽  
Indigenous Australians ◽  
New Governance ◽  
Remote Communities ◽  
Aboriginal Communities ◽  
The Government

In the late 1970s thousands of Indigenous Australians initiated a movement back to the ancestral lands they had been removed from during the assimilationist era. Less than 50 years since their return to country, Aboriginal people living in Western Australia’s (WA) remote communities are again grappling with their impending redispossession. Wa Premier Colin Barnett’s announcement late last year was panic inducing: It is a problem that I do not want and the government does not want, but it is a reality. There are something like 274 Aboriginal communities in Western Australia—I think 150 or so of those are in the Kimberley itself—and they are not viable. They are not viable and they are not sustainable . . . I am foreshadowing that a number of communities are inevitably going to close.

scholarly journals Smart Indigenous Youth: The Smart Platform Policy Solution for Systems Integration to Address Indigenous Youth Mental Health

10.2196/21155 ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. e21155
Author(s):  
Tarun Reddy Katapally
Keyword(s):  
Mental Health ◽  
Digital Health ◽  
Community Based Participatory Research ◽  
Indigenous Communities ◽  
Youth Mental Health ◽  
Public Health Issue ◽  
Culturally Appropriate ◽  
Rural And Remote ◽  
Indigenous Youth ◽  
School Curricula

Indigenous youth mental health is an urgent public health issue, which cannot be addressed with a one-size-fits-all approach. The success of health policies in Indigenous communities is dependent on bottom-up, culturally appropriate, and strengths-based prevention strategies. In order to maximize the effectiveness of these strategies, they need to be embedded in replicable and contextually relevant mechanisms such as school curricula across multiple communities. Moreover, to engage youth in the twenty-first century, especially in rural and remote areas, it is imperative to leverage ubiquitous mobile tools that empower Indigenous youth and facilitate novel Two-Eyed Seeing solutions. Smart Indigenous Youth is a 5-year community trial, which aims to improve Indigenous youth mental health by embedding a culturally appropriate digital health initiative into school curricula in rural and remote Indigenous communities in Canada. This policy analysis explores the benefits of such upstream initiatives. More importantly, this article describes evidence-based strategies to overcome barriers to implementation through the integration of citizen science and community-based participatory research action.

scholarly journals A holistic approach to capacity building: For professionals working with indigenous communities

2020 ◽  
Author(s):  
◽  
Jennifer Parisian
Keyword(s):  
Capacity Building ◽  
First Nations ◽  
Aboriginal People ◽  
Holistic Approach ◽  
Indigenous Communities ◽  
Common Goal ◽  
Holistic Understanding ◽  
History Of ◽  
The Common ◽  
Approach Working

The history of Education in Canada has been systemically and generational destructive to Aboriginal people and culture. This history of destruction has caused systemic racism throughout our school systems resulting in lower graduation rates and a lack of equity in achievement within education resulting in gaps in social-economic disparity for Aboriginal People in Canada (Archibald & Hare, 2017). This research project aims to address a gap in the education of educators in regard to closing the gap and working together for reconciliation. This project provides a framework for a holistic understanding of how to approach working within First Nations communities within the education system or across systems. The result of this project is a guidebook and PowerPoint presentation for professional development. The project provides educational professionals with some tools and knowledge to improve inclusive and culturally sensitive practice. The project delivers a common goal framework conceptualized by the researcher and adapted from a generalized, personal, and interpretative understanding of the Aboriginal Medicine Wheel. The four-part conceptual framework includes leadership, holistic approach, capacity building, and ethical considerations with the common goal in the center. The project brings together the concepts important to achieving the common goal of improving professional capacity when working with Aboriginal People and First Nations communities.

scholarly journals Smart Indigenous Youth: The Smart Platform Policy Solution for Systems Integration to Address Indigenous Youth Mental Health (Preprint)

2020 ◽  
Author(s):  
Tarun Reddy Katapally
Keyword(s):  
Mental Health ◽  
Digital Health ◽  
Community Based Participatory Research ◽  
Indigenous Communities ◽  
Youth Mental Health ◽  
Public Health Issue ◽  
Culturally Appropriate ◽  
Rural And Remote ◽  
Indigenous Youth ◽  
School Curricula

UNSTRUCTURED Indigenous youth mental health is an urgent public health issue, which cannot be addressed with a one-size-fits-all approach. The success of health policies in Indigenous communities is dependent on bottom-up, culturally appropriate, and strengths-based prevention strategies. In order to maximize the effectiveness of these strategies, they need to be embedded in replicable and contextually relevant mechanisms such as school curricula across multiple communities. Moreover, to engage youth in the twenty-first century, especially in rural and remote areas, it is imperative to leverage ubiquitous mobile tools that empower Indigenous youth and facilitate novel Two-Eyed Seeing solutions. Smart Indigenous Youth is a 5-year community trial, which aims to improve Indigenous youth mental health by embedding a culturally appropriate digital health initiative into school curricula in rural and remote Indigenous communities in Canada. This policy analysis explores the benefits of such upstream initiatives. More importantly, this article describes evidence-based strategies to overcome barriers to implementation through the integration of citizen science and community-based participatory research action.

Study Protocol:Missing Voices– Communication Difficulties after Stroke and Traumatic Brain Injury in Aboriginal Australians

2015 ◽  
Vol 16 (2) ◽  
pp. 145-156 ◽  
Author(s):  
Elizabeth Armstrong ◽  
Deborah Hersh ◽  
Judith M. Katzenellenbogen ◽  
Juli Coffin ◽  
Sandra C. Thompson ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Service Delivery ◽  
Screening Tool ◽  
Aboriginal People ◽  
Culturally Appropriate ◽  
Aboriginal Australians ◽  
Service Delivery Models ◽  
Aboriginal Populations ◽  
Delivery Models

Background:Aboriginal and Torres Strait Islander Australians experience stroke and traumatic brain injury (TBI) with much greater frequency than non-Aboriginal Australians. Acquired communication disorders (ACD) can result from these conditions and can significantly impact everyday life. Yet few Aboriginal people access rehabilitation services and little is known about Aboriginal peoples’ experiences of ACD. This paper describes the protocol surrounding a study that aims to explore the extent and impact of ACD in Western Australian Aboriginal populations following stroke or TBI and develop a culturally appropriate screening tool for ACD and accessible and culturally appropriate service delivery models.Method/Design:The 3-year, mixed methods study is being conducted in metropolitan Perth and five regional centres in Western Australia. Situated within an Aboriginal research framework, methods include an analysis of linked routine hospital admission data and retrospective file audits, development of a screening tool for ACD, interviews with people with ACD, their families, and health professionals, and drafting of alternative service delivery models.Discussion:This study will address the extent of ACD in Aboriginal populations and document challenges for Aboriginal people in accessing speech pathology services. Documenting the burden and impact of ACD within a culturally secure framework is a forerunner to developing better ways to address the problems faced by Aboriginal people with ACD and their families. This will in turn increase the likelihood that Aboriginal people with ACD will be diagnosed and referred to professional support to improve their communication, quality of life and functioning within the family and community context.

Systems of Oppression in Geriatric Clinical Service Delivery

2021 ◽  
pp. 1-3
Author(s):  
Diane L. Kendall
Keyword(s):  
Higher Education ◽  
Service Delivery ◽  
Clinical Setting ◽  
Service Providers ◽  
Hard Work ◽  
Clinical Service ◽  
Meaningful Change ◽  
Important Work ◽  
Speech Language Pathologists ◽  
Medical Institutions

Purpose The purpose of this article was to extend the concepts of systems of oppression in higher education to the clinical setting where communication and swallowing services are delivered to geriatric persons, and to begin a conversation as to how clinicians can disrupt oppression in their workplace. Conclusions As clinical service providers to geriatric persons, it is imperative to understand systems of oppression to affect meaningful change. As trained speech-language pathologists and audiologists, we hold power and privilege in the medical institutions in which we work and are therefore obligated to do the hard work. Suggestions offered in this article are only the start of this important work.

Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽  
2019 ◽  
Vol 40 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Chris Rouen ◽  
Alan R. Clough ◽  
Caryn West
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Care Center ◽  
Indigenous Communities ◽  
Indigenous Australians ◽  
Deliberate Self Harm ◽  
Health Care Center ◽  
Far North ◽  
Primary Health ◽  
Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

scholarly journals Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review

2021 ◽  
Vol 6 (3) ◽  
pp. e004484
Author(s):  
Helen Burn ◽  
Lisa Hamm ◽  
Joanna Black ◽  
Anthea Burnett ◽  
Matire Harwood ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Service Delivery ◽  
Indigenous Peoples ◽  
Indigenous Communities ◽  
High Income ◽  
Eye Care ◽  
Service Delivery Models ◽  
Care Services ◽  
Delivery Models ◽  
Improve Access

PurposeGlobally, there are ~370 million Indigenous peoples. Indigenous peoples typically experience worse health compared with non-Indigenous people, including higher rates of avoidable vision impairment. Much of this gap in eye health can be attributed to barriers that impede access to eye care services. We conducted a scoping review to identify and summarise service delivery models designed to improve access to eye care for Indigenous peoples in high-income countries.MethodsSearches were conducted on MEDLINE, Embase and Global Health in January 2019 and updated in July 2020. All study designs were eligible if they described a model of eye care service delivery aimed at populations with over 50% Indigenous peoples. Two reviewers independently screened titles, abstracts and full-text articles and completed data charting. We extracted data on publication details, study context, service delivery interventions, outcomes and evaluations, engagement with Indigenous peoples and access dimensions targeted. We summarised findings descriptively following thematic analysis.ResultsWe screened 2604 abstracts and 67 studies fulfilled our eligibility criteria. Studies were focused on Indigenous peoples in Australia (n=45), USA (n=11), Canada (n=7), New Zealand (n=2), Taiwan (n=1) and Greenland (n=1). The main disease focus was diabetic retinopathy (n=30, 45%), followed by ‘all eye care’ (n=16, 24%). Most studies focused on targeted interventions to increase availability of services. Fewer than one-third of studies reported involving Indigenous communities when designing the service. 41 studies reflected on whether the model improved access, but none undertook rigorous evaluation or quantitative assessment.ConclusionsThe geographical and clinical scope of service delivery models to improve access to eye care for Indigenous peoples in high-income countries is narrow, with most studies focused on Australia and services for diabetic retinopathy. More and better engagement with Indigenous communities is required to design and implement accessible eye care services.

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