Exercise-based interventions for Indigenous adults with chronic lung disease in Australia, Canada, New Zealand, and USA: a systematic review

Abstract

Indigenous peoples in Australia, New Zealand, Canada, and the United States of America (USA) have a higher burden of chronic lung disease than non-Indigenous people. Exercised-based interventions, such as pulmonary rehabilitation, are highly effective to manage chronic lung disease. The outcomes of these interventions for Indigenous people require evaluation. The aim of this review was to critically appraise the literature on the impact of exercise-based interventions on quality of life, exercise capacity and health care utilisation in Indigenous adults with chronic lung disease in Australia,

COPD disease knowledge, self-awareness and reasons for hospital presentations among a predominately Indigenous Australian cohort: a study to explore preventable hospitalisation

“…It may be reasonable to speculate that the disparity in symptom manifestations (cough and sputum) noted among Indigenous patients could be attributed to coexistent bronchiectasis and COPD. Airway clearance manoeuvres are paramount in the management of bronchiectasis;42 however, implementation or intervention outcomes are sparsely reported in the literature in the management of chronic respiratory conditions among Indigenous people 21 43. It is plausible that by providing dedicated chest physiotherapy/airway clearance programmes that are accessible and available for Indigenous people living in remote communities that we would see benefits not only in the overall management of chronic respiratory conditions but also in terms of outcomes such as recurrent hospital admissions due to exacerbations of airway disease.…”

Implementing evidence into practice to improve chronic lung disease management in Indigenous Australians: the breathe easy, walk easy, lungs for life (BE WELL) project (protocol)

“…ACCHS are primary care services [ 35 ] initiated and operated by the local Aboriginal community to deliver holistic, comprehensive, and culturally appropriate health care to their community and were established due to the inability to properly engage Indigenous peoples in mainstream Australian health services [ 36 ]. Programs of rehabilitation for chronic lung disease are not usually core business of ACCHS which is exemplified by a recent systematic review which was only able to report one study where a PR program was provided within an ACCHS [ 12 ]. This paucity of data on the implementation of PR programs within ACCHS and the uptake by Indigenous people with COPD needs to be addressed if we are to close the gap in outcomes.…”

“…A recent systematic review of PR for Indigenous peoples with COPD in Australia, Canada, New Zealand and the United States of America found only one published study reporting the outcomes of PR, [ 12 ] highlighting the paucity of data evaluating PR in Indigenous communities.…”

Inequality in Pulmonary Rehabilitation – The challenges magnified by the COVID-19 pandemic

“… 1 , 2 Ethnic and indigenous health disparities have been observed in high-income countries in prevalence, severity, hospital admissions and mortality associated with COPD. 3 – 5 These observed health inequalities may be attributable to: shared behavioural risk factors (e.g., smoking, unhealthy diet, physical inactivity), environmental factors (e.g., exposure to air pollution and biomass smoke), cultural differences in perceptions of health and healthcare, differences in education level and health literacy, motivation to engage in self-care interventions and self-efficacy. 1 – 5 …”

“…[3][4][5] These observed health inequalities may be attributable to: shared behavioural risk factors (e.g., smoking, unhealthy diet, physical inactivity), environmental factors (e.g., exposure to air pollution and biomass smoke), cultural differences in perceptions of health and healthcare, differences in education level and health literacy, motivation to engage in self-care interventions and self-efficacy. [1][2][3][4][5] Pulmonary rehabilitation (PR) data demonstrate that people living with COPD in more socioeconomically deprived areas are less likely to complete PR than their counterparts living in the least deprived areas [6][7][8] ; although clinical outcomes of those who do complete are comparable to those from less deprived areas. 6 The ethnicity of PR attendees in the UK remains predominantly White-British 7 and significantly lower completion rates have been reported in M aori and Pacific Islanders in comparison to Europeans in a New Zealand cohort.…”