The objective of this scoping review was to map the current practice and best evidence for embedding cultural safety in child protection responses for Aboriginal families in hospitals. Electronic databases were searched systematically and the reference lists examined. Efforts to reduce the risk of bias were made including using an inductive approach. Eight research papers were included following the exclusion of 25 papers for the final analysis. Three main themes in relation to what is necessary to embed cultural safety for Aboriginal families when child protection responses are raised in hospital were found. These were (a) relationships, (b) organisational processes and (c) culture. The analysis underscores the need for development of child protection strategies that focus on cultural safety rather than cultural competence alone. This provides some direction for policy and practice development in this field, and has also highlighted the deficiencies in evidence and urgent need for further research.
Purpose – Nurse home visiting programmes designed to reduce the likelihood of child maltreatment in families at risk have been widely implemented in Australia and overseas. The purpose of this paper is to examine the intensity and duration of maternal involvement in a nurse home visiting programme to prevent child maltreatment. Design/methodology/approach – A retrospective, longitudinal design was employed. The clinical records of 40 mothers who had received nurse home visits following the birth of a new baby for at least six months, and had provided consent for their details to be accessed for research purposes, were selected for analysis. The influence of antenatal characteristics and well-being on maternal involvement in a nurse home visiting programme was examined using reliability of change indices. Findings – Mothers with impaired family functioning reporting they experienced violence at home were more likely to leave the programme early and received fewer than the prescribed number of home visits compared to mothers who had been enroled into the programme for other complex psychosocial needs. At the same time, mothers enroled on the basis of impaired psychological functioning and who did not report violence in the home remained, and received more than the prescribed number of home visits over the course of their involvement. Originality/value – Results showed that domestic violence increased the risk of poor engagement with a targeted nurse home visiting programme. At the same time, home visitors responded to complex individual and family needs by increasing the number of home visits accordingly. This theoretically based pilot research has helped to disentangle antecedents of maternal involvement and the subsequent impact on programme outcomes. Further investigation using a larger study sample is needed.
We consider here the potentialities of drawing on the cultural strengths and resilience of Australian's First Nations families for their engagement with child protection (CP) and healthcare services. We disentangle the underlying historical and systemic failures driving the crisis of Australia's First Nations children coming into CP in disproportionate numbers. This is a difficult, complex, and evolving area of reform with scant empirical evidence-questions abound more than solutions. Our core message is this: a public health approach to CP requires better logical frameworks informed by more research and evaluation, driven by the cultural strengths of First Nations Australians. We outline key reforms through an intersectional approach between the healthcare and CP systems, and between cultural competence and cultural safety, using an interprofessional communication tool. We argue that deficit thinking toward First Nations peoples is embedded within culturally dangerous dominant discourses. Contemporary reforms have failed to redress this. Monocultural institutions including healthcare and CP services must address racism-"cultural safety" needs to underpin policy and practice. Crucially, we assert that power rests in the hands of First Nations peoples to determine if the care provided to their communities is culturally safe. Governance, policy, and practice must authentically embrace culturally safe practices, confronting deeply held social norms, biases, and assumptions. Organizational processes, culture, and relationships are core components in culturally safe environments and we outline a number of research and workforce development strategies. Fundamental are strengthbased approaches to empower First Nations people's self-determination, control, and collaboration in systemic changes.
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