Understanding the importance of connection: an indigenous exploration of the social and emotional well-being and resilience of a rural cohort of Aboriginal young people
Our story began in the pursuit of understanding Aboriginal young experiences of resilience and well-being. This was achieved by adopting an Aboriginal story method, combined with thematic analysis using winanga-li (to listen, to hear, to know and to remember) to hear and listen to the young people's stories, a method presented by Kovach ([2010].Indigenous Methodologies: Characteristics, Conversations, and Contexts. Toronto: University of Toronto Press.) to honour the talk. This paper presents Aboriginal young people's views and experiences of resilience and well-being. Using a qualitative approach, we conducted yarning interviews with 15 Aboriginal young people. Our analysis revealed the overarching themes of belonging, experiencing distress, being strong, recognising risk and maintaining positivity, which is comprised of a set of subthemes to exemplify multiple layers of well-being and resilience for the young people in this study. These findings confirm the absolute importance of connections, culture and community to young Aboriginal people and expose the distress that results from the loss of these relationships and connections. Given the known link between connections to culture, health and well-being implications, the findings of this study have relevance for clinicians, researchers, and policy-makers.
Understanding the Impact of Historical Trauma Due to Colonization on the Health and Well-Being of Indigenous Young Peoples: A Systematic Scoping Review
Introduction: Indigenous Peoples are experiencing the ongoing effects of colonization. This phenomenon, historical trauma (HT), helps to address the current ill-health disparity. Aim of this scoping review was to identify sources of evidence available to understand the impact of HT on Indigenous young peoples. Method: A scoping review was conducted on available evidence-based literature. Article quality was assessed using validated quality appraisal tools. Synthesis was conducted with predefined levels of impact. Results: Consistent with the literature, the themes and levels of impact were interrelated. Despite this, studies predominately reported a singular focus with limited discussion of protective factors. Discussion: HT continues to have a profound impact on Indigenous young peoples across Canada, Australia, New Zealand, and the United States. Protective factors for HT were evident within Indigenous research designs. Future research should ensure a multilevel focus to explore intergenerational strength and how this influences culturally congruent health care.
Influence of COVID-19 on the preventive health behaviours of indigenous peoples of Australia residing in New South Wales: a mixed-method study protocol
Introduction Chronic conditions impact indigenous peoples of Australia at a much higher rate than non-indigenous Australians. Attendance at the Medicare Benefits Scheme (MBS) supported indigenous health checks are crucial to improve prevention and management of chronic health conditions. However, in conjunction with lifestyle and environmental factors, attendance rates at primary healthcare services for screening and treatment have fallen in Australia during the COVID-19 pandemic. This study aims to explore the influence of the COVID-19 pandemic on preventive health behaviours of indigenous Australians and the associated barriers to, and enablers of, engagement with health services to formulate a targeted intervention strategy.
Methods and analysis A concurrent mixed-methods study (comprising quantitative and qualitative data collection methods) will be employed. Descriptive analysis of MBS data about the characteristics of indigenous peoples of Australia claiming health assessment services will be performed. Generalised estimating equation regression models will be used to examine the use of health assessment services over time. Qualitative interviews informed by indigenous research methods will be conducted. Interviews will investigate barriers to, and enablers of, engagement with health services. Thematic approach guided by the principles of indigenist praxis, storytelling and collaborative research will be used to analyse the interview data. The project commenced in July 2020 and will be completed by July 2022.
Ethics and dissemination The project received ethics approval from the Aboriginal Health and Medical Research Council of New South Wales and the University of New England Human Research Ethics Committee. Findings will be disseminated via peer-reviewed journal articles, conferences, government and relevant stakeholder reports, and infographics.
Preventative health assessments and indigenous people of Australia: A scoping review
Given that Indigenous populations globally are impacted by similar colonial global legacies, their health and other disaprities are usually worse than nonindigenous people. Indigenous peoples of Australia have been seriously impacted by colonial legacies and as a result, their health has negatively been affected. If Indigenous health and wellbeing are to be promoted within the existing Australian health services, a clear understanding of what preventive health means for Indigenous peoples is needed. The aim of this scoping review was to explore the available literature on the uptake/engagement in health assessments or health checks by Indigenous Australian peoples and to determine the enablers and barriers and of health assessment/check uptake/engagement. Specifically, we aimed to: investigate the available evidence reporting the uptake/engagement of health checks/assessments for Australian Indigenous; assess the quality of the available evidence on indigenous health checks/assessments; and identify the enablers or barriers affecting Indigenous persons’ engagement and access to health assessment/health checks. A systematic search of online databases (such as Cinhl, Scopus, ProQuest health and medicine, PubMed, informit, Google Scholar and google) identified 10 eligible publications on Indigenous preventive health assessments. Reflexive thematic analysis identified three major themes on preventive health assessments: (1) uptake/engagement; (2) benefits and limitations; and (3) enablers and barriers. Findings revealed that Indigenous peoples’ uptake and/or engagement in health assessments/check is a holistic concept varied by cultural factors, gender identity, geographical locations (living in regional and remote areas), and Indigenous clinical leadership/staff’s motivational capacity. Overall, the results indicate that there has been improving rates of uptake of health assessments by some sections of Indigenous communities. However, there is clearly room for improvement, both for aboriginal men and women and those living in regional and remote areas. In addition, barriers to uptake of health asessments were identified as length of time required for the assessment, intrusive or sensitive questions and shame, and lack of access to health services for some. Indigenous clinical leadership is needed to improve services and encourage Indigenous people to participate in routine health assessments.
De-problematising Aboriginal young peoples' health and well-being through their voice: An Indigenous scoping review
Background: The continued use of a deficit discourse when researching Aboriginal and Torres Strait Islander Peoples of Australia is problematic. Understanding and challenging the researchers position and the power of the words they use is important. It will ensure we do not persist in framing Aboriginal and Torres Strait Islander People as a problem to be solved.
Design: Indigenist review of the evidence of Aboriginal young people's health and well-being.
Methods: This review was conducted using an Indigenist approach to identify texts which amplified the voices of Aboriginal young people of Australia and presents a narrative summary of their accounts. This review is reported in line with the PRISMA-ScR reporting guidelines.
Results: Culture and connection are critical components of Aboriginal young people's health and well-being. Aboriginal young people describe feeling of powerlessness to influence health and well-being of their community, and they understood the risks they and their communities faced. Young people identified the importance of connection to culture, community and Elders as crucial to their social and emotional well-being.
Conclusion: By harnessing an Indigenous analysis, we were able to reveal a strong counter narrative of strength and resilience within their historical, social, and political contexts through the storied accounts of Aboriginal young people.
Relevance to clinical practice: Most of the currently available evidence about Aboriginal health and well-being is immersed in deficit discourse. Literature reviews being the foundation of research and informing nursing practice, we call for a purposeful shift towards the adoption of an Indigenist strength-based approach which emphasises the strength and resilience of Aboriginal young people.
COVID-19 and social restrictions: the potential mental health impact of social distancing and isolation for young Indigenous Australians
Dear Sir,
In Australia, the COVID-19 outbreak has generated swift and aggressive public health responses aimed at reducing the spread of infection. While these have been effective in curbing the outbreak in Australia, there is an increasing concern for the mental health impacts of ongoing socially restrictive measures. Despite the Prime Minister's urgings that 'we are all in this together', there is burgeoning evidence that the burden of this pandemic will not be equally shared and some are 'more in than others'. Effective measures to provide public health protection for all Australians including Indigenous Australians should be accompanied by additional effort to ameliorate the mental health consequences for those already at higher risk as a consequence of the burden of adverse social determinants.
A unified call to action from Australian nursing and midwifery leaders: ensuring that Black lives matter
Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a 'now window' of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.
Indigenous Resilience in Australia: A Scoping Review Using a Reflective Decolonizing Collective Dialogue
Contemporary definitions and understandings of resilience refer to an individual's positive adaptation to the experience of adversity. One of the challenges of this extant body of work is that the central concept of resilience is rarely questioned. Current understandings of these concepts, largely framed in Western understandings, are unquestioningly accepted, reframed for, yet not by, Indigenous peoples, and then are unchallenged when imposed on Indigenous peoples. A scoping review was conducted and reported in line with the PRISMA-ScR guidelines. The review involved the participation of local Aboriginal Research Cultural Advisory Groups who participated in and approved the analysis of the findings and collaborated on the design and writing of the paper. Eight publications drew on Aboriginal constructs of resilience in examining the effectiveness of programs, processes, and practices to promote individual and/or collective resilience and well-being. Most studies emphasized the need for strategies to strengthen individual or community connection to culture to foster resilience. Six studies used culturally validated strength-based tools to measure resilience, while two relied on Western constructs. This review reveals both the distinctive colonial characteristics of adversity experienced by Aboriginal people and the range of coping strategies and protective resources that support the development of resilience within different Aboriginal communities in diverse research sites across Australia. Importantly, many studies confirm adversity is linked to the enduring legacies of colonization, continuous and cumulative transgenerational grief and loss, structural inequities, racism, and discrimination. These external factors of adversity are unique to Aboriginal populations, as are the protective factors that entail strengthening connection to culture (including language reclamation), community, ancestry and land (including management and economic development) which contribute to individual and collective resilience. These findings suggest that Aboriginal community resilience is strengthened through the collective experience of adversity, such as transgenerational grief and loss, and the resulting support structures and shared resources that are developed and maintained through cultural practices to strengthen the bonds and mutual reciprocity to participate in transformative strategies to address adversity. This review highlights that strategies such as building on community strengths, capacities, and resources is critical when strengthening resilience within Indigenous communities across Australia.