International Journal of Environmental Research and Public Health, 2022
Research remains a site of struggle for First Nations peoples globally. Biomedical research often... more Research remains a site of struggle for First Nations peoples globally. Biomedical research often reinforces existing power structures, perpetuating ongoing colonisation by dominating research priorities, resource allocation, policies, and services. Addressing systemic health inequities requires decolonising methodologies to facilitate new understandings and approaches. These methodologies promote a creative tension and productive intercultural dialogue between First Nations and Western epistemologies. Concurrently, the potential of critical theory, social science, and community participatory action research approaches to effectively prioritise First Nations peoples’ lived experience within the biomedical worldview is increasingly recognised. This article describes learnings regarding research methods that enable a better understanding of the lived experience of rheumatic heart disease—an intractable, potent marker of health inequity for First Nations Australians, requiring long-ter...
Improving healthcare for Aboriginal Australians through effective engagement between community an... more Improving healthcare for Aboriginal Australians through effective engagement between community and health services: guide to evaluation questions. (DOCX 23 kb)
Traditionally, Indigenous men and women maintained distinct gendered realities. Colonisation and ... more Traditionally, Indigenous men and women maintained distinct gendered realities. Colonisation and the subsequent introduction of the patriarchal system altered these realities, negatively impacting on Indigenous men's and women's health and wellbeing in a cumulative and continuing way. This literature review provides an overview of gendered Indigenous perspectives of health and wellbeing, and discusses some of the intervention strategies in Australia that have attempted to address these issues. In providing a context for understanding gendered Indigenous health perspectives, this literature review discusses the place of Indigenous peoples in contemporary Australian society and the complex historical factors that inform the relationship between Indigenous and non-Indigenous peoples. The research involved a review of gendered Indigenous health literature involving a systematic search of peer-reviewed and grey literature, and government and non-government reports. This work comm...
International Journal of Environmental Research and Public Health, 2021
While disparities in educational outcomes for Aboriginal children have narrowed in early childhoo... more While disparities in educational outcomes for Aboriginal children have narrowed in early childhood education and for Year 12 completions, these positive trends are not replicated in the intervening years where attendance, reading, writing, and numeracy targets have been missed. Erratic attendance in the primary years has the greatest impact on achievement; literacy and numeracy scores decline as absences increase. Family functioning and health, caregiver expectations, past encounters with the education system and socio-economic disadvantage are all implicated in poorer rates of attendance. In response to community concerns, an Aboriginal/mainstream partnership was forged in 2011 and began work in 2016 to address patterns of attendance and achievement among Aboriginal primary students in a regional city in Western Australia. This paper describes the innovative, community-led “More Than Talk” program and presents findings from teaching and support staff interviews two years after impl...
This paper presents four poems collaboratively developed and performed at an intensive research-w... more This paper presents four poems collaboratively developed and performed at an intensive research-writing workshop held by members of the Health Node of the National Indigenous Research and Knowledges Network (NIRAKN). The workshop encouraged participants to develop scholarly publications through collaboration between Indigenous and non-Indigenous researchers who worked together through mutual respect and a range of creative writing processes. The poem-writing practice was a positive, stimulating experience for participants. It demonstrated the value of using creative practice as part of scholarly research. The poetry writing helped to explore participants' underlying views about research, kick-started the writing process, and supported Indigenous, collaborative, non-competitive approaches to research.
This chapter discusses and defines the difference between multidisciplinary and interdisciplinary... more This chapter discusses and defines the difference between multidisciplinary and interdisciplinary/interprofessional care with a focus on interdisciplinary care as a model of practice which supports equality and interconnectedness of responsibility amongst team members when working in Aboriginal and Torres Strait Islander contexts. The chapter describes the various professional and para professional practitioners that comprise interdisciplinary teams working in mental health and wellbeing contexts and their roles. The focus is on an interdisciplinary team approach to providing health and wellbeing care as its ethos of equal relationships and interdependent collaboration is more encompassing of social and emotional wellbeing values. Identification of the issues and limitations of interdisciplinary practice and the means to addressing them are explored within the context of how interdisciplinary care fits into mental health best practice and human rights.
Background Community engagement in Aboriginal health research aims to protect and empower partici... more Background Community engagement in Aboriginal health research aims to protect and empower participating individuals and communities and is an ethical requirement in research. One approach to incorporating community engagement in research is to engage a community reference group to provide oversight and cultural guidance to projects. The aim of this study was to describe the process of establishing a community reference group and terms of reference to guide the Enhancing Equity, Collaboration and Culturally secure Osteoarthritis care for Aboriginal Australians collaboration (ECCO). ECCO is a national inter-professional team of Aboriginal and non-Aboriginal health service staff and researchers that was established to develop culturally secure osteoarthritis care for Aboriginal people. Methods This was a two-phase study conducted in Victoria, Australia. In phase one, semi-structured research yarns were conducted collaboratively by Aboriginal and non-Aboriginal co-investigators to explo...
Research undertaken by outsiders into issues of concern to Aboriginal communities frequently igno... more Research undertaken by outsiders into issues of concern to Aboriginal communities frequently ignores community culture and the knowledge embedded within Aboriginal communities. Methodologies are adopted which perpetuate the colonialist mindset of non-indigenous Australians leading to failed solutions to Aboriginal problems. This paper describes an Aboriginal-led community-based research project, exploring the role of Aboriginal Australians in caring for, and transforming, their own communities. It focuses on the roles that Information Systems can play when providing an accessible platform for Aboriginal voices. The authors conducted an in-depth case study of one Aboriginal Community Controlled Organisation (ACCO), the Illawarra Koori Men’s Support Group (IKMSG). The research consisted of a social network analysis (SNA) of the inter-organisational links of the IKMSG; interviews and focus groups with members of the IKMSG and the co-design of their first website. The prominence of the ...
In common with colonized Indigenous people worldwide, many Australian Aboriginal people experienc... more In common with colonized Indigenous people worldwide, many Australian Aboriginal people experience inequitable health outcomes. While the commitment and advocacy of researchers and health practitioners has resulted in many notable improvements in policy and practice, systemic and structural impediments continue to restrain widespread gains in addressing Indigenous health injustices. We take Rheumatic Heart Disease (RHD), a potent marker of extreme health inequity, as a case study, and critically examine RHD practitioners' perspectives regarding the factors that need to be addressed to improve RHD prevention and care. This study is an important explanatory component of a broader study to inform new clinical practices, and health system strategies and policies to reduce RHD. A decolonising, critical medical anthropology (CMA) analysis of findings from 22 RHD practitioner in-depth interviews conducted in May 2016 revealed both practitioners' perceptions of health system shortcomings and a sense of hopelessness and powerlessness to transform existing health system inequities, the negative impacts of which were subsequently confirmed in a separate study of RHD patients' lived realities. We reveal how biomedical dominance, normalized deficit discourses and systemic racism influence the current policy and practice landscape, narrowing the intercultural space for productive dialogue and reinforcing the conditions that cause disease. To counter biomedical approaches that contribute to existing health inequities in health care, we recommend localized, strength-based, community-led research projects focused on actions that use critical decolonizing social science approaches to achieve system change. We demonstrate the importance of integrating biological and social sciences approaches in research, education/training, and practice to: 1) be guided by Indigenous strengths, knowledges and worldview, and 2) adopt a critical reflexive stance to examine systems, structures and practices. Such an approach facilitates productive cross-cultural dialogue and social transformation; providing direction and hope to practitioners, enhancing their knowledge, skills and capacity and improving Aboriginal health outcomes.
Background Documented rates of dementia and cognitive impairment not dementia (CIND) in older Abo... more Background Documented rates of dementia and cognitive impairment not dementia (CIND) in older Aboriginal and Torres Strait Islander Peoples is 3–5 times higher than the rest of the population, and current evidence suggests this condition is under-diagnosed and under-managed in a clinical primary care setting. This study aims to implement and evaluate a culturally responsive best practice model of care to optimise the detection and management of people with cognitive impairment and/or dementia, and to improve the quality of life of carers and older Aboriginal and Torres Islander Peoples with cognitive impairment. Methods/design The prospective study will use a stepped-wedge cluster randomised controlled trial design working with 12 Aboriginal Community Controlled Health Services (ACCHSs) across four states of Australia. Utilising a co-design approach, health system adaptations will be implemented including (i) development of a best practice guide for cognitive impairment and dementia...
Issue addressedResearch suggests that young Indigenous people want carers to take a more active r... more Issue addressedResearch suggests that young Indigenous people want carers to take a more active role in discussions about sexual health. The aim of this study was to ascertain carers’ perspectives of: the importance of providing young people with information about sex and sexual health; what they want young people to know about sex and sexual health; and facilitators and barriers to discussing sex and sexual health with youth.MethodsThirteen focus groups and three interviews were conducted with 81 carers in four rural and urban regions of Western Australia. Data were coded using a thematic approach, analysed using inductive Framework Analysis, and interpreted using the Aboriginal Family Wellbeing Model of Empowerment.ResultsMany participants recognised the need for talking with young people about sex, and said they drew upon resources such as books, pamphlets and television and used humour to impart lessons. However, a large proportion of participants reported difficulties in educat...
International Journal of Environmental Research and Public Health, 2022
Research remains a site of struggle for First Nations peoples globally. Biomedical research often... more Research remains a site of struggle for First Nations peoples globally. Biomedical research often reinforces existing power structures, perpetuating ongoing colonisation by dominating research priorities, resource allocation, policies, and services. Addressing systemic health inequities requires decolonising methodologies to facilitate new understandings and approaches. These methodologies promote a creative tension and productive intercultural dialogue between First Nations and Western epistemologies. Concurrently, the potential of critical theory, social science, and community participatory action research approaches to effectively prioritise First Nations peoples’ lived experience within the biomedical worldview is increasingly recognised. This article describes learnings regarding research methods that enable a better understanding of the lived experience of rheumatic heart disease—an intractable, potent marker of health inequity for First Nations Australians, requiring long-ter...
Improving healthcare for Aboriginal Australians through effective engagement between community an... more Improving healthcare for Aboriginal Australians through effective engagement between community and health services: guide to evaluation questions. (DOCX 23 kb)
Traditionally, Indigenous men and women maintained distinct gendered realities. Colonisation and ... more Traditionally, Indigenous men and women maintained distinct gendered realities. Colonisation and the subsequent introduction of the patriarchal system altered these realities, negatively impacting on Indigenous men's and women's health and wellbeing in a cumulative and continuing way. This literature review provides an overview of gendered Indigenous perspectives of health and wellbeing, and discusses some of the intervention strategies in Australia that have attempted to address these issues. In providing a context for understanding gendered Indigenous health perspectives, this literature review discusses the place of Indigenous peoples in contemporary Australian society and the complex historical factors that inform the relationship between Indigenous and non-Indigenous peoples. The research involved a review of gendered Indigenous health literature involving a systematic search of peer-reviewed and grey literature, and government and non-government reports. This work comm...
International Journal of Environmental Research and Public Health, 2021
While disparities in educational outcomes for Aboriginal children have narrowed in early childhoo... more While disparities in educational outcomes for Aboriginal children have narrowed in early childhood education and for Year 12 completions, these positive trends are not replicated in the intervening years where attendance, reading, writing, and numeracy targets have been missed. Erratic attendance in the primary years has the greatest impact on achievement; literacy and numeracy scores decline as absences increase. Family functioning and health, caregiver expectations, past encounters with the education system and socio-economic disadvantage are all implicated in poorer rates of attendance. In response to community concerns, an Aboriginal/mainstream partnership was forged in 2011 and began work in 2016 to address patterns of attendance and achievement among Aboriginal primary students in a regional city in Western Australia. This paper describes the innovative, community-led “More Than Talk” program and presents findings from teaching and support staff interviews two years after impl...
This paper presents four poems collaboratively developed and performed at an intensive research-w... more This paper presents four poems collaboratively developed and performed at an intensive research-writing workshop held by members of the Health Node of the National Indigenous Research and Knowledges Network (NIRAKN). The workshop encouraged participants to develop scholarly publications through collaboration between Indigenous and non-Indigenous researchers who worked together through mutual respect and a range of creative writing processes. The poem-writing practice was a positive, stimulating experience for participants. It demonstrated the value of using creative practice as part of scholarly research. The poetry writing helped to explore participants' underlying views about research, kick-started the writing process, and supported Indigenous, collaborative, non-competitive approaches to research.
This chapter discusses and defines the difference between multidisciplinary and interdisciplinary... more This chapter discusses and defines the difference between multidisciplinary and interdisciplinary/interprofessional care with a focus on interdisciplinary care as a model of practice which supports equality and interconnectedness of responsibility amongst team members when working in Aboriginal and Torres Strait Islander contexts. The chapter describes the various professional and para professional practitioners that comprise interdisciplinary teams working in mental health and wellbeing contexts and their roles. The focus is on an interdisciplinary team approach to providing health and wellbeing care as its ethos of equal relationships and interdependent collaboration is more encompassing of social and emotional wellbeing values. Identification of the issues and limitations of interdisciplinary practice and the means to addressing them are explored within the context of how interdisciplinary care fits into mental health best practice and human rights.
Background Community engagement in Aboriginal health research aims to protect and empower partici... more Background Community engagement in Aboriginal health research aims to protect and empower participating individuals and communities and is an ethical requirement in research. One approach to incorporating community engagement in research is to engage a community reference group to provide oversight and cultural guidance to projects. The aim of this study was to describe the process of establishing a community reference group and terms of reference to guide the Enhancing Equity, Collaboration and Culturally secure Osteoarthritis care for Aboriginal Australians collaboration (ECCO). ECCO is a national inter-professional team of Aboriginal and non-Aboriginal health service staff and researchers that was established to develop culturally secure osteoarthritis care for Aboriginal people. Methods This was a two-phase study conducted in Victoria, Australia. In phase one, semi-structured research yarns were conducted collaboratively by Aboriginal and non-Aboriginal co-investigators to explo...
Research undertaken by outsiders into issues of concern to Aboriginal communities frequently igno... more Research undertaken by outsiders into issues of concern to Aboriginal communities frequently ignores community culture and the knowledge embedded within Aboriginal communities. Methodologies are adopted which perpetuate the colonialist mindset of non-indigenous Australians leading to failed solutions to Aboriginal problems. This paper describes an Aboriginal-led community-based research project, exploring the role of Aboriginal Australians in caring for, and transforming, their own communities. It focuses on the roles that Information Systems can play when providing an accessible platform for Aboriginal voices. The authors conducted an in-depth case study of one Aboriginal Community Controlled Organisation (ACCO), the Illawarra Koori Men’s Support Group (IKMSG). The research consisted of a social network analysis (SNA) of the inter-organisational links of the IKMSG; interviews and focus groups with members of the IKMSG and the co-design of their first website. The prominence of the ...
In common with colonized Indigenous people worldwide, many Australian Aboriginal people experienc... more In common with colonized Indigenous people worldwide, many Australian Aboriginal people experience inequitable health outcomes. While the commitment and advocacy of researchers and health practitioners has resulted in many notable improvements in policy and practice, systemic and structural impediments continue to restrain widespread gains in addressing Indigenous health injustices. We take Rheumatic Heart Disease (RHD), a potent marker of extreme health inequity, as a case study, and critically examine RHD practitioners' perspectives regarding the factors that need to be addressed to improve RHD prevention and care. This study is an important explanatory component of a broader study to inform new clinical practices, and health system strategies and policies to reduce RHD. A decolonising, critical medical anthropology (CMA) analysis of findings from 22 RHD practitioner in-depth interviews conducted in May 2016 revealed both practitioners' perceptions of health system shortcomings and a sense of hopelessness and powerlessness to transform existing health system inequities, the negative impacts of which were subsequently confirmed in a separate study of RHD patients' lived realities. We reveal how biomedical dominance, normalized deficit discourses and systemic racism influence the current policy and practice landscape, narrowing the intercultural space for productive dialogue and reinforcing the conditions that cause disease. To counter biomedical approaches that contribute to existing health inequities in health care, we recommend localized, strength-based, community-led research projects focused on actions that use critical decolonizing social science approaches to achieve system change. We demonstrate the importance of integrating biological and social sciences approaches in research, education/training, and practice to: 1) be guided by Indigenous strengths, knowledges and worldview, and 2) adopt a critical reflexive stance to examine systems, structures and practices. Such an approach facilitates productive cross-cultural dialogue and social transformation; providing direction and hope to practitioners, enhancing their knowledge, skills and capacity and improving Aboriginal health outcomes.
Background Documented rates of dementia and cognitive impairment not dementia (CIND) in older Abo... more Background Documented rates of dementia and cognitive impairment not dementia (CIND) in older Aboriginal and Torres Strait Islander Peoples is 3–5 times higher than the rest of the population, and current evidence suggests this condition is under-diagnosed and under-managed in a clinical primary care setting. This study aims to implement and evaluate a culturally responsive best practice model of care to optimise the detection and management of people with cognitive impairment and/or dementia, and to improve the quality of life of carers and older Aboriginal and Torres Islander Peoples with cognitive impairment. Methods/design The prospective study will use a stepped-wedge cluster randomised controlled trial design working with 12 Aboriginal Community Controlled Health Services (ACCHSs) across four states of Australia. Utilising a co-design approach, health system adaptations will be implemented including (i) development of a best practice guide for cognitive impairment and dementia...
Issue addressedResearch suggests that young Indigenous people want carers to take a more active r... more Issue addressedResearch suggests that young Indigenous people want carers to take a more active role in discussions about sexual health. The aim of this study was to ascertain carers’ perspectives of: the importance of providing young people with information about sex and sexual health; what they want young people to know about sex and sexual health; and facilitators and barriers to discussing sex and sexual health with youth.MethodsThirteen focus groups and three interviews were conducted with 81 carers in four rural and urban regions of Western Australia. Data were coded using a thematic approach, analysed using inductive Framework Analysis, and interpreted using the Aboriginal Family Wellbeing Model of Empowerment.ResultsMany participants recognised the need for talking with young people about sex, and said they drew upon resources such as books, pamphlets and television and used humour to impart lessons. However, a large proportion of participants reported difficulties in educat...
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Papers by Dawn Bessarab