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Objective: To investigate the potential of record linkage between the Australian Bureau of Statistics (ABS) mortality data and the NSW Admitted Patient Data Collection (APDC) to improve reporting of deaths among Aboriginal and Torres Strait Islander peoples. Methods: ABS mortality data for 2002 to 2006 were linked with APDC records for 2001 to 2006. Six algorithms were developed to enumerate deaths. Possible biases by age, sex and geographic remoteness were investigated. Results: Levels of reporting ranged from baseline reporting on the ABS mortality data to the largest enhancement with the ‘ever reported as Aboriginal or Torres Strait Islander’ algorithm. Enhancement was more likely in females, older people and residents of major cities. Conclusions: Data linkage substantially improved reporting of Aboriginal and Torres Strait Islander deaths. An algorithm that includes both the number of APDC records and the number of facilities reporting a person as Aboriginal or Torres Strait Islander was considered most promising. Implications: Inclusion of other datasets in the enhancement process is warranted to further improve reporting and address possible bias produced by using APDC records only. Further work should take into account the possibility that a person may be falsely reported as Aboriginal or Torres Strait Islander or not reported in either hospital or death records.

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Objectives:To describe the pattern of infant feeding at discharge from care after birth and the characteristics of mothers who are at risk of low rates of breastfeeding. Methods: Data were obtained from the NSW Midwives Data Collection for 2007. Information on infant feeding was obtained for babies who were alive at discharge from care after birth. Of 96 030 births reported, 93 505 (97.4%) were eligible for analysis. A descriptive analysis of factors associated with variations in breastfeeding was carried out. Results: In 2007, 80% of babies were fully breastfed, 7% were partially breastfed, and 13% were not breastfed. Babies born to mothers with the following characteristics had relatively low rates of full breastfeeding: teenage mothers (69%); Aboriginal mothers (64%); mothers born in South-East Asia (71%), North-East Asia (72%) and Melanesia, Micronesia and Polynesia (74%); mothers who commenced antenatal care later than 20 weeks gestation (74%); mothers who smoked (67%); mothers who received general anaesthetic during delivery (67%); mothers who gave birth by caesarean section (76%); mothers living in the most socially disadvantaged areas (73%); mothers living in remote and very remote areas (73% and 76% respectively); and mothers of preterm infants (70%). Conclusion: There is a need to improve overall rates of breastfeeding initiation in NSW. Particular attention and support needs to be given to the groups of mothers identified in this study as having relatively low rates of full breastfeeding.

Transnational migration of refugees is associated with poor mental health, particularly among children. We conducted a pilot trial of the Family Strengthening Intervention for Refugees (FSI-R), using a community-based participatory research (CBPR) approach to deliver a home-based intervention “for refugees by refugees” to improve family functioning and child mental health. N = 80 refugee families in the Greater Boston area participated in the study ( n = 40 Somali Bantu families; n = 40 Bhutanese families) with n = 41 families randomized to care-as-usual. Of the 39 families who received FSI-R, n = 36 caregivers and children completed qualitative exit interviews. We present findings from these interviews to identify the mechanisms through which a family-strengthening intervention for refugees can be acceptable, feasible, and effective at improving family functioning and children's mental health outcomes. Authors applied Grounded Theory to code interview transcripts and detailed field notes and used an iterative process to arrive at final codes, themes, and a theoretical framework. The greatest contributors to acceptability and feasibility included flexibility in scheduling intervention sessions, the interventionist being a community member, and improvements to family communication and time spent together. All of these factors were made possible by the CBPR approach. Our findings suggest that given the socio-political context within the U.S. and the economic challenges faced by refugee families, the successful implementation of such interventions hinges on culturally-grounding the intervention design process, drawing heavily on community input, and prioritizing community members as interventionists.