Health and wellbeing outcomes of programs for Indigenous Australians that include strategies to enable the expression of cultural identities: a systematic review

Abstract

Abstract. Indigenous people have long maintained that strong cultural identities are critical to health and wellbeing. The purpose of this systematic review is to examine whether interventions that entail strategies to enable expression of cultural identities for Australian Indigenous peoples are associated with measurable improvements in health and wellbeing. Peer-reviewed articles that reported quantitatively expressed health and wellbeing outcomes involving Indigenous Australian participants only were included. The cultural intervention component was defined and assessed by Indigenous researchers on the team. A narrative analysis was conducted. The protocol was registered on PROSPERO (CRD420 15027387). Thirteen articles describing eleven studies were identified, including one randomised control trial (RCT), one cluster RCT and two studies with non-randomised controls. Other studies reported on case series or cross-sectional studies. All except two studies described multiple intervention strategies. Eight studies showed significant improvement in at least one psychosocial, behavioural or clinical measure, with two showing a positive direction of effect and one showing no improvement. Publication bias may discourage researchers to report negative findings of these interventions. Although studies vary in quality, this review provides evidence that interventions that include opportunities for expression of cultural identities can have beneficial effects for Australian Indigenous peoples.

Inclusion, acceptance, shame and isolation: Attitudes to autism in Aboriginal and Torres Strait Islander communities in Australia

“…Gilroy and Emerson (2016) have reported that Indigenous children with low cognitive ability may be at a higher risk of social exclusion than their peers. This finding is concerning because research has suggested that cultural experiences play an integral role in positive health and wellbeing outcomes for Australian Indigenous peoples (MacLean et al, 2017). One mother in our study reported that in her Torres Strait Island community it was difficult to include her son in valued cultural activities, suggesting that while an inclusive ethos may be predominant, it is important to remain aware of the possibility of exclusion.…”

“Aquí (en Sídney) estamos perdidos”: estudio etnográfico de la satisfacción vital de aborígenes urbanos australianos participantes en un programa sociocomunitario

“…En el caso de las poblaciones jóvenes, existe un corpus creciente de evidencias de que la participación en las actividades tradicionales no solo puede contribuir a fortalecer los lazos familiares, sino que puede ser un factor protector para la salud, especialmente para la depresión y el abuso de sustancias (51) . Este hallazgo es también consistente con la revisión sistemática sobre programas de intervención cultural elaborada por Maclean (19) : de los 11 programas analizados, 10 mostraron que la inclusión de componentes culturales para facilitar SALUD COLECTIVA. 2020;16:e2553.…”

“…Entre las medidas emergentes para paliar las carencias de estas poblaciones urbanas surgió una creciente implementación de programas sociorecreativos, diseñados con el objetivo de mejorar la calidad de vida y la inclusión social de las comunidades aborígenes (16,17,18) . A lo largo de los últimos años, la bibliografía científica ha ido generando un corpus cada vez más sólido de evidencias sobre el impacto positivo, a nivel biopsicosocial, que supone incorporar prácticas imbricadas a representaciones tradicionales de la identidad cultural a los programas de intervención comunitaria (17,18,19,20,21) . En el caso concreto de las poblaciones aborígenes, han sido de especial interés los programas específicos con fines lúdico-recreativos, conectados a áreas como la educación y la integración social (21,22) .…”

Aboriginal and Torres Strait Islander health

“…A key message these research papers convey is the importance of community-driven, culture strengthening interventions in primary healthcare settings. For Aboriginal and Torres Strait Islander peoples this message would be self-evident, and Maclean et al present evidence that interventions promoting expression of cultural identities have beneficial effects (MacLean et al 2017). Taking a community wide approach to address social determinants and strengthen cultural identity was more effective than narrow biomedical approaches in addressing youth suicide (Cox et al 2014), pyoderma (Thomas et al 2017), the content of health assessments (Spurling et al 2017), and food insecurity (Murray et al 2014).…”