Putting urban Aboriginal and Torres Strait Islander food insecurity on the agenda

2017 ◽  
Vol 23 (5) ◽  
pp. 415 ◽  
Author(s):  
Leigh Bramwell ◽  
Wendy Foley ◽  
Tanya Shaw
Keyword(s):  
Food Insecurity ◽  
Torres Strait Islander ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Torres Strait Islander People ◽  
Social Wellbeing ◽  
Primary Health ◽  
Health Advice ◽  
Torres Strait ◽  
Primary Healthcare Providers

Food insecurity adversely affects diet quality, physical, mental and social wellbeing and the capacity to act on health advice recommended by primary healthcare providers. In this article, an overview of the neglected issue of food insecurity in urban Aboriginal and Torres Strait Islander communities is provided. Policy and action on food security for urban Aboriginal and Torres Strait Islander people is reviewed, and it is argued that for primary health care to better address food insecurity, an evidence base is needed to understand the experiences of individuals and households and how to work effectively to support food insecure clients.

scholarly journals (Murradambirra Dhangaang - Make Food Secure) Aboriginal Community and Stakeholder Perspectives on Food Insecurity in Urban and Regional Australia: A Qualitative Study

2021 ◽  
Author(s):  
Simone Sherriff ◽  
Deanna Kalucy ◽  
Allison Tong ◽  
Nawazish Naqvi ◽  
Janice Nixon ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Torres Strait Islander ◽  
Local Food ◽  
System Level ◽  
Torres Strait Islander People ◽  
Aboriginal Communities ◽  
Aboriginal Community ◽  
Stakeholder Perspectives ◽  
Torres Strait ◽  
Regional Australia

Abstract Background: Food insecurity affects one in five Aboriginal and Torres Strait Islander people residing in non-remote environments. Inequalities in diet contribute to the differential impact on diet-sensitive chronic diseases and the related burden of disease among Aboriginal and Torres Strait Islander people. This study aimed to describe Aboriginal community and stakeholder perspectives on food insecurity to get a better understanding of the key factors driving this issue and recommendations for potential solutions in urban and regional Aboriginal communities in Australia. Methods: Semi-structured interviews were conducted with 44 participants who were purposively selected. This included Aboriginal people in two communities and both Aboriginal and non-Aboriginal stakeholders from local food relief agencies, food suppliers, schools, and government. A conceptual framework was developed from food insecurity literature and we used the sensitizing concepts of availability, affordability, accessibility and acceptability or the lack thereof of healthy food to elicit interview responses. Interview transcripts were analysed thematically. Results: All participants felt strongly that food insecurity was a major problem experienced in the local Aboriginal communities. Five core areas impacting on food security identified: trapped in financial disadvantage; gaps in the local food system; limitations of non-Aboriginal food relief services; on-going impacts of colonization; and maintaining family, cultural and community commitments and responsibilities. Conclusions: This study found Aboriginal families in urban and regional Australia are experiencing food insecurity on a regular basis, which is impacted by a range of socio-economic, environmental, systemic and cultural factors, as reported by the participants. Our findings highlight the need to address system level changes in the food environment and acknowledge Aboriginal culture and food preferences while considering the development of programs to alleviate food insecurity among urban and regional communities.

Interventions to address food insecurity among Aboriginal and Torres Strait Islander people: A rapid review

2021 ◽  
Author(s):  
Fiona H McKay ◽  
Stephanie L Godrich
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Torres Strait Islander ◽  
Significant Risk ◽  
Rapid Review ◽  
Small Scale ◽  
Torres Strait Islander People ◽  
Health And Wellbeing ◽  
Change Projects ◽  
Torres Strait

Food insecurity disproportionately impacts Aboriginal and Torres Strait Islander Australians. This review sought to investigate research and evaluations of programs and interventions implemented to address food insecurity among Aboriginal and Torres Strait Islander communities. A rapid review was conducted to collate the available research from six databases. The search was conducted in May 2020. Search constructs related to food insecurity, Aboriginal and Torres Strait Islander people, and Australia. 25 publications were included in this review, 24 reported on an intervention, while nine were evaluations of an intervention. Interventions included behaviour change projects, including projects that sought to change purchasing and cooking behaviours, school-based education programs, and gardening programs. In general, the studies included in this sample were small, and lacked a systematic consideration of the factors that shape the experience of food insecurity among Aboriginal and Torres Strait Islander people specifically. Based on the findings of this review, authors suggest greater consideration to the systematic determinants of food insecurity among Aboriginal and Torres Strait Islander communities to have lasting and sustainable impact on food insecurity. This review has been registered with the international prospective register of systematic reviews (PROSPERO: CRD42020183709). Novelty bullets • Food insecurity among Aboriginal and Torres Strait Islander people poses significant risk to health and wellbeing. • Small scale food security interventions may not provide ongoing and sustained impact. • Any intervention to promote food security will need to involve Aboriginal and Torres Strait Islander people and be sustained once external parties have left.

scholarly journals What Matters 2 Adults (WM2Adults): Understanding the Foundations of Aboriginal and Torres Strait Islander Wellbeing

2021 ◽  
Vol 18 (12) ◽  
pp. 6193
Author(s):  
Gail Garvey ◽  
Kate Anderson ◽  
Alana Gall ◽  
Tamara L. Butler ◽  
Joan Cunningham ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Large Scale ◽  
Torres Strait Islander ◽  
Evidence Base ◽  
Holistic Health ◽  
Research Approach ◽  
Torres Strait Islander People ◽  
Torres Strait ◽  
And Control ◽  
Health Purpose

Aboriginal and Torres Strait Islander people experience a greater range of health and social disadvantages compared to other Australians. Wellbeing is a culturally-bound construct, and to date, a national evidence base around the components of wellbeing for Aboriginal and Torres Strait Islander people is lacking. Understanding and measurement of wellbeing for this population is critical in achieving health equity. This paper aims to identify and describe the foundations of wellbeing for Aboriginal and Torres Strait Islander adults. This national qualitative study was underpinned by an Indigenist research approach which privileges the voices of Aboriginal and Torres Strait Islander people. Aboriginal and Torres Strait Islander adults were purposively recruited from around Australia between September 2017 and September 2018 to participate in Yarning Circles, led by Aboriginal and Torres Strait Islander researchers. Yarning Circles were audio recorded, transcribed and analyzed. A Collaborative Yarning Methodology was used, which incorporated reflexive thematic analysis to identify and describe the foundations of wellbeing reported by participants. A total of 359 Aboriginal and Torres Strait Islander adults participated. Our analysis revealed five foundations of wellbeing: belonging and connection; holistic health; purpose and control; dignity and respect; and basic needs. These foundations were deeply interwoven by three interconnected aspects of Aboriginal and Torres Strait Islander life: family, community and culture. The findings of this study will substantially aid our efforts to develop a new wellbeing measure for Aboriginal and Torres Strait Islander adults. The iterative Indigenist methods used in this study provide a robust research methodology for conducting large-scale, nationally-relevant qualitative research with Aboriginal and Torres Strait Islander people. Policies and practices that are informed by our results have the potential to address outcomes that are meaningful for Aboriginal and Torres Strait Islander people.

scholarly journals Evaluation of Electronic Mental Health Implementation in Northern Territory Services Using the Integrated “Promoting Action on Research Implementation in Health Services” Framework: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Buaphrao Raphiphatthana ◽  
Michelle Sweet ◽  
Stefanie Puszka ◽  
Megan Whitty ◽  
Kylie Dingwall ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Torres Strait Islander ◽  
Service Providers ◽  
Mental Health Training ◽  
Torres Strait Islander People ◽  
Primary Health ◽  
Torres Strait ◽  
Primary Health Care Settings

BACKGROUND Electronic mental health is a promising strategy to bridge the treatment gap in mental health care. Training workshops have been delivered to service providers working with Aboriginal and Torres Strait Islander people at a primary health care level to raise awareness and knowledge of electronic mental health approaches. OBJECTIVE This study aimed to understand service providers’ perspectives and experiences of electronic mental health adoption. More specifically, it aimed to use the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to further identify and understand how different factors facilitate or impede electronic mental health uptake within primary health care settings providing services to Aboriginal and Torres Strait Islander people. METHODS Qualitative interviews were conducted with 57 service providers working with Aboriginal and Torres Strait Islander people, who had undergone electronic mental health training workshops. RESULTS Several factors related to innovation (electronic mental health approach), recipients (service providers as an individual and as a team), and context (local, organizational, and external contexts) were found to influence electronic mental health uptake. Particularly, organizational readiness, in terms of information technology resources and infrastructure, policies, workforce and culture, and processes to mandate electronic mental health use, were found to be significant impediments to electronic mental health utilization. These findings led to the development of a three-phase implementation strategy that aims to enhance electronic mental health adoption by addressing organizational readiness before and post electronic mental health training. CONCLUSIONS The i-PARIHS provides a useful determinant framework that deepens our understanding of how different factors impede or facilitate electronic mental health adoption in this setting. This insight was used to develop a practical and comprehensive implementation strategy to enhance the utilization of electronic mental health approaches within primary health care settings, involving three phases: pretraining consultations, training workshops, and post-training follow-up support.

scholarly journals Evaluation of Electronic Mental Health Implementation in Northern Territory Services Using the Integrated “Promoting Action on Research Implementation in Health Services” Framework: Qualitative Study

10.2196/14835 ◽  
2020 ◽  
Vol 7 (5) ◽  
pp. e14835
Author(s):  
Buaphrao Raphiphatthana ◽  
Michelle Sweet ◽  
Stefanie Puszka ◽  
Megan Whitty ◽  
Kylie Dingwall ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Torres Strait Islander ◽  
Service Providers ◽  
Mental Health Training ◽  
Torres Strait Islander People ◽  
Primary Health ◽  
Torres Strait ◽  
Primary Health Care Settings

Background Electronic mental health is a promising strategy to bridge the treatment gap in mental health care. Training workshops have been delivered to service providers working with Aboriginal and Torres Strait Islander people at a primary health care level to raise awareness and knowledge of electronic mental health approaches. Objective This study aimed to understand service providers’ perspectives and experiences of electronic mental health adoption. More specifically, it aimed to use the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to further identify and understand how different factors facilitate or impede electronic mental health uptake within primary health care settings providing services to Aboriginal and Torres Strait Islander people. Methods Qualitative interviews were conducted with 57 service providers working with Aboriginal and Torres Strait Islander people, who had undergone electronic mental health training workshops. Results Several factors related to innovation (electronic mental health approach), recipients (service providers as an individual and as a team), and context (local, organizational, and external contexts) were found to influence electronic mental health uptake. Particularly, organizational readiness, in terms of information technology resources and infrastructure, policies, workforce and culture, and processes to mandate electronic mental health use, were found to be significant impediments to electronic mental health utilization. These findings led to the development of a three-phase implementation strategy that aims to enhance electronic mental health adoption by addressing organizational readiness before and post electronic mental health training. Conclusions The i-PARIHS provides a useful determinant framework that deepens our understanding of how different factors impede or facilitate electronic mental health adoption in this setting. This insight was used to develop a practical and comprehensive implementation strategy to enhance the utilization of electronic mental health approaches within primary health care settings, involving three phases: pretraining consultations, training workshops, and post-training follow-up support.

scholarly journals How can dementia diagnosis and care for Aboriginal and Torres Strait Islander people be improved? Perspectives of healthcare providers providing care in Aboriginal community controlled health services

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jamie Bryant ◽  
Natasha Noble ◽  
Megan Freund ◽  
Jennifer Rumbel ◽  
Sandra Eades ◽  
...  
Keyword(s):  
Health Services ◽  
Torres Strait Islander ◽  
Healthcare Providers ◽  
Dementia Diagnosis ◽  
Torres Strait Islander People ◽  
High Quality ◽  
Aboriginal Community ◽  
Barriers And Enablers ◽  
Care Assessment ◽  
Torres Strait

Abstract Background Aboriginal and/or Torres Strait Islander people experience dementia at a rate three to five times higher than the general Australian population. Aboriginal Community Controlled Health Services (ACCHSs) have a critical role to play in recognising symptoms of cognitive impairment, facilitating timely diagnosis of dementia, and managing the impacts of dementia. Little is known about the barriers and enablers to Aboriginal people receiving a timely dementia diagnosis and appropriate care once diagnosed. This study aims to explore, from the perspective of healthcare providers in the ACCHS sector across urban, regional and remote communities, the barriers and enablers to the provision of dementia diagnosis and care. Methods A qualitative study involving semi-structured interviews with staff members working in the ACCHS sector. Aboriginal Health Workers, General Practitioners, nurses, practice or program managers, and Chief Executive Officers were eligible to participate. Consenting ACCHS staff completed a telephone interview administered by a trained interviewer. Interviews were audio-recorded, transcribed, and analysed using qualitative content analysis. Results Sixteen staff from 10 ACCHSs participated. Most participants perceived their communities had a limited understanding of dementia. Symptoms of dementia were usually noticed by the GP or another healthcare worker at the ACCHS who had an ongoing relationship with the person. Most participants reported that their service had established referral pathways with either hospital-based geriatricians, geriatricians located with aged care assessment teams, or specialists who visited communities periodically. Key enablers to high quality dementia care included the use of routine health assessments as a mechanism for diagnosis; relationships within communities to support diagnosis and care; community and family relationships; comprehensive and holistic care models; and the use of tailored visual resources to support care. Key barriers to high quality care included: denial and stigma; dementia being perceived as a low priority health condition; limited community awareness and understanding of dementia; lack of staff education and training about dementia; and numerous gaps in service delivery. Conclusions Substantially increased investments in supporting best-practice diagnosis and management of dementia in Aboriginal communities are required. ACCHSs have key strengths that should be drawn upon in developing solutions to identified barriers to care.

scholarly journals Access to Aboriginal Community-Controlled Primary Health Organizations Can Explain Some of the Higher Pap Test Participation Among Aboriginal and Torres Strait Islander Women in North Queensland, Australia

2021 ◽  
Vol 11 ◽  
Author(s):  
Paramita Dasgupta ◽  
John R. Condon ◽  
Lisa J. Whop ◽  
Joanne F. Aitken ◽  
Gail Garvey ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Local Community ◽  
Negative Binomial ◽  
Cervical Screening ◽  
Point Estimate ◽  
Access To Health Services ◽  
Torres Strait Islander People ◽  
Primary Health ◽  
Screening Participation ◽  
Torres Strait

BackgroundAboriginal and Torres Strait Islander Community-Controlled Health Organisations (ACCHOs) provides culturally appropriate primary care for Aboriginal and Torres Strait Islander people in Australia. The population of North Queensland has a higher proportion of Aboriginal and Torres Strait Islander people, a greater population coverage of ACCHOs, and higher cervical screening participation than the Rest of Queensland. The association between regional differences in the use of ACCHOs for cervical screening and variations in screening participation among Aboriginal and Torres Strait Islander women is currently unknown.MethodsThis is a population-based study of 1,107,233 women, aged 20–69 years who underwent cervical screening between 2013 and 2017. Of these women, 132,972 (12%) were from North Queensland, of which 9% were identified as Aboriginal and Torres Strait Islander women (2% Rest of Queensland) through linkage to hospital records. Regional differentials in screening by Aboriginal and Torres Strait Islander status were quantified using participation rate ratios (PRRs) with 95% confidence intervals (CIs) from negative binomial regression models. Logistic regression was used to identify factors associated with Aboriginal and Torres Strait Islander women being screened at ACCHOs.ResultsAboriginal and Torres Strait Islander women from North Queensland (versus) Rest of Queensland had higher odds of screening at ACCHOs after adjusting for age and area-level variables. After adjustment for non-ACCHO variables, the regional differential in screening among Aboriginal and Torres Strait Islander women was significantly higher (PRR 1.28, 95% CI 1.20–1.37) than that among other Australian women [PRR = 1.11 (1.02–1.18)], but was attenuated on further adjustment for ACCHO variables, [PRR = 1.15, (1.03–1.28)] to become similar to the corresponding point estimate for other Australian women [PRR = 1.09, (1.01–1.20)]. However, the significant interaction between Aboriginal and Torres Strait Islander status and region (p < 0.001) remained, possibly reflecting the large cohort size. Screening participation increased with better access to health services for all women.ConclusionsImproving access to primary health care for Aboriginal and Torres Strait Islander women, especially through ACCHOs, may reduce existing disparities in cervical screening participation. Further gains will require greater levels of local community engagement and understanding of the experiences of screened Aboriginal and Torres Strait Islander women to inform effective interventions.

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