Investing in the health of Aboriginal and Torres Strait Islander adolescents: a foundation for achieving health equity

Azzopardi, Peter; Blow, Ngaree; Purcell, Tara; Brown, Ngiare; Ritchie, Tirritpa; Brown, Alex

doi:10.5694/mja2.50500

Cited by 29 publications

(31 citation statements)

References 6 publications

(21 reference statements)

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“…These improvements are underpinned by partnerships, engagement, collaboration, agreed values, participatory CQI, and tailored workforce training in systems integration approaches. The study also contributes to a specific policy focus on Indigenous children's wellbeinga necessary focus if the Australian government's new Closing the Gap socio-economic targets are to be attained [75][76][77].…”

Section: Discussionmentioning

confidence: 99%

Systems integration to promote the mental health of Aboriginal and Torres Strait Islander children: protocol for a community-driven continuous quality improvement approach

McCalman

Bainbridge

James³

et al. 2020

BMC Public Health

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Background Systems integration to promote the mental health of Aboriginal and Torres Strait Islander children works towards developing a spectrum of effective, community-based services and supports. These services and supports are organised into a coordinated network, build meaningful partnerships with families and address their cultural and linguistic needs, to help children to function better at home, in school, in the community, and throughout life. This study is conducted in partnership with primary healthcare (PHC) and other services in three diverse Indigenous Australian communities. It entails conceptualising, co-designing, implementing, and evaluating the effectiveness of systems integration to promote the mental health and wellbeing of Indigenous school-aged children (4–17 years). This paper outlines a protocol for implementing such complex community-driven research. Methods/design Using continuous quality improvement processes, community co-designed strategies for improved systems integration will be informed by narratives from yarning circles with Indigenous children and service providers, and quantitative data from surveys of service providers and audits of PHC client records and intersectoral systems. Agreed strategies to improve the integration of community-based services and supports will be modelled using microsimulation software, with a preferred model implemented in each community. The evaluation will investigate changes in the: 1) availability of services that are community-driven, youth-informed and culturally competent; 2) extent of collaborative service networks; 3) identification by PHC services of children’s social and emotional wellbeing concerns; and 4) ratio of children receiving services to identified need. Costs and benefits of improvements to systems integration will also be calculated. Discussion The study will provide evidence-informed, community-driven, and tested models that can be used for implementing systems integration to promote the mental health and wellbeing of Indigenous children. It will identify the situational enablers and barriers that impact systems integration and determine the extent to which systems integration improves service availability, systems and child outcomes. Evidence for the cost effectiveness of systems-level integration will contribute to national mental health policy reform.

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Section: Discussionmentioning

confidence: 99%

Systems integration to promote the mental health of Aboriginal and Torres Strait Islander children: protocol for a community-driven continuous quality improvement approach

McCalman

Bainbridge

James³

et al. 2020

BMC Public Health

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“…23 As many Indigenous peoples worldwide have younger populations compared with their non-Indigenous counterparts, 24 the impetus to include Indigenous youth is both a matter of democratic representation and responsibility as well as centred within conversations on decolonisation, cultural continuity and supporting younger generations to promote and sustain healthy Indigenous futures. [25][26][27][28][29] Despite various efforts to conceptualise and operationalise Indigenous youth participation in health equity promotion, 6 there remains important questions on how to articulate participation that extends across disciplinary, cultural and geographical boundaries. No comprehensive review exists to unify conceptual definitions of Indigenous youth participation in the broader domain of health equity and detail pathways toward inclusion, decolonisation and improving health outcomes.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Integrative review protocol for Indigenous youth participation in health equity promotion

2022

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IntroductionIndigenous youth participation in decision-making is internationally recognised as a pathway to promote health equity, decolonisation and social inclusion. Hearing Indigenous youth voices and actively involving them in decisions that affect their lives and their communities has the potential to address disproportionate health and social challenges they encounter. Yet the existing evidence-base on participatory approaches remains fragmented and vast leading to a lack of integration.Methods and analysisAn integrative review methodology will be used to conduct a comprehensive, multidisciplinary review of the literature about Indigenous youth participation in health equity promotion. The literature search is anticipated to be carried out in July–August 2022. We will search online databases Scopus, Ovid MEDLINE, Embase and PsycINFO along with several interdisciplinary databases indexed in EBSCOhost and ProQuest. Key Indigenous research journals not consistently indexed in the online databases will be examined to identify additional journal articles. We will employ a blinded, dual-reviewer two-step selection process with established inclusion/exclusion criteria and limit data to English-language publications related to Indigenous populations in Canada, USA, Aotearoa New Zealand and Australia. Focusing on qualitative empirical and theoretical studies, they will undergo quality appraisal and Covidence software will be used to manage the review. Data will be sorted, extracted and analysed. We will codify data for descriptive reporting and conduct a narrative synthesis to identify a common conceptualisation for Indigenous youth participatory approaches across disciplines, its barriers and facilitators, and knowledge gaps.Ethics and disseminationEthical review is not required for the integrative review. The review will be shared through various publication and non-academic platforms as well as our university and community research networks. Findings will have broad relevance for those seeking to involve Indigenous youth to be active decision-makers across a range of fields, but with specific implications for health equity.

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“…The implications of this project are substantial with strengthened primary care for young people having the potential to improve population health and reduce health inequities. 1 Adolescents represent a third of the Aboriginal and Torres Strait Islander population, and their health needs are substantial and largely unmet. Improving health at this time of life, particularly when young people are establishing their identity, transitioning from education to employment, and developing new relationships has the potential for long-lasting impacts.…”

Section: Ethicsmentioning

confidence: 99%

“…One-third of the Australian Aboriginal and Torres Strait Islander population are aged 10–24 years; these adolescents central to assuring the prosperity and cultural continuity of Australia’s First People. 1 However, as highlighted by two recent publications, Aboriginal and Torres Strait Islander adolescents have substantial health needs that are unmet by current services. 2 3 In summary, Aboriginal and Torres Strait Islander adolescents experience a heavy burden of mental disorders, suicide and self-harm, sexually transmitted infection, and injury (health conditions typical of adolescence); an excess burden of pneumonia and skin infections (more typical of childhood); an early onset of type 2 diabetes (more typical of adulthood); and a high burden of rheumatic heart disease and bronchiectasis (otherwise rare in Australia).…”

Section: Introductionmentioning

confidence: 99%

Enablers and barriers to primary healthcare for Aboriginal and Torres Strait Islander adolescents: study protocol for participatory mixed-methods research that builds on WHO global standards

et al. 2021

Self Cite

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IntroductionOne-third of Australia’s Aboriginal and Torres Strait Islander population are adolescents. Recent data highlight their health needs are substantial and poorly met by existing services. To design effective models of primary healthcare, we need to understand the enablers and barriers to care for Aboriginal and Torres Strait Islander adolescents, the focus of this study.Methods and analysisThis protocol was codesigned with Apunipima Cape York Health Council that supports the delivery of primary healthcare for 11 communities in Far North Queensland. We framed our study around the WHO global standards for high-quality health services for adolescents, adding an additional standard around culturally safe care. The study is participatory and mixed methods in design and builds on the recommended WHO assessment tools. Formative qualitative research with young people and their communities (exploring concepts in the WHO recommended quantitative surveys) seeks to understand demand-side enablers and barriers to care, as well as preferences for an enhanced response. Supply-side enablers and barriers will be explored through: a retrospective audit of clinic data (to identify current reasons for access and what can be strengthened); an objective assessment of the adolescent friendliness of clinical spaces; anonymous feedback from adolescent clients around quality of care received and what can be improved; and surveys and qualitative interviews with health providers to understand their perspectives and needs to provide enhanced care. This codesigned project has been approved by Apunipima Cape York Health Council and Far North Queensland Human Research Ethics Committee.Dissemination and implicationsThe findings from this project will inform a codesigned accessible and responsive model of primary healthcare for Aboriginal and Torres Strait Islander adolescents.

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Investing in the health of Aboriginal and Torres Strait Islander adolescents: a foundation for achieving health equity

Cited by 29 publications

References 6 publications

Systems integration to promote the mental health of Aboriginal and Torres Strait Islander children: protocol for a community-driven continuous quality improvement approach

Systems integration to promote the mental health of Aboriginal and Torres Strait Islander children: protocol for a community-driven continuous quality improvement approach

Integrative review protocol for Indigenous youth participation in health equity promotion

Enablers and barriers to primary healthcare for Aboriginal and Torres Strait Islander adolescents: study protocol for participatory mixed-methods research that builds on WHO global standards

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