Addressing unresolved tensions to build effective partnerships: Lessons from an Aboriginal cancer support network

Background: Cancer is the second leading cause of death among Aboriginal and Torres Strait Islander people and their survival once diagnosed with cancer is lower compared to that of other Australians. This highlights the need to improve cancer-related health services for Indigenous Australians although how to achieve this remains unclear. Cancer support groups provide emotional and practical support, foster a sense of community and belonging and can improve health outcomes. However, despite evidence on their positive effects on people affected by cancer, there is scarce information on the function and effectiveness of Indigenous-specific cancer peer-support programs in Australia. Using qualitative data from an evaluation study, this paper explores different understandings of how a cancer support group should operate and the impact of unresolved tensions following the establishment of an Indigenous women cancer peer-support network in a regional town in Western Australia. Methods: Data were collected through semi-structured interviews with 24 participants purposively selected among Indigenous and mainstream healthcare service providers, and group members and clients. Interviews were audiotaped and transcribed verbatim. Transcripts were subjected to inductive thematic analysis. NVivo was used to manage the data and assist in the data analysis. Rigour was enhanced through team member checking, coding validation and peer debriefing. Results: Flexibility and a resistance to formal structuring were at the core of how the group operated. It was acknowledged that the network partly owned its success to its fluid approach; however, most mainstream healthcare service providers believed that a more structured approach was needed for the group to be sustainable. This was seen as acting in opposition to the flexible, organic approach considered necessary to adequately respond to Indigenous women's needs. At the core of these tensions were opposing perspectives on the constructs of 'structure' and 'flexibility' between Indigenous and non-Indigenous participants. Conclusions: Despite the group's achievements, unresolved tensions between opposing perspectives on how a support group should operate negatively impacted on the working relationship between the group and mainstream service providers, and posed a threat to the Network's sustainability. Our results support the need to acknowledge and address different perspectives and world views in order to build strong, effective partnerships between service providers and Indigenous communities

Enhancing activity, nutrition and mental health in overweight adolescents Stage 1 - Formative Research

This report discusses Stage 1 of the 'Curtin Activity, Food and Attitudes Program' (CAFAP). As a part of this research program, a tertiary hospital adolescent obesity intervention was adapted and piloted it in a community setting with clinically obese adolescents and their families. The first stage of the project refined the program and its evaluation framework based on individual, family and community enablers and barriers. This report will present the outcomes of Stage 1. It will examine the experiences of participants and discuss the understanding gained of what would encourage potential participants to become involved in CAFAP if it was available to them in their community

Community intervention to increase seafood consumption (CIISC)

In summary, this report describes a whole of community intervention aimed at increasing consumption of seafood. The health benefits of seafood were reviewed and a suit of communication materials developed including: primary and secondary education models. vocational eductaion materials, resources for general practitioners and point of sale materials. Evaluation of project outcomes revealed an increase in seafood consumption during and one month after the intervention period

Medical student views of and responses to expectations of professionalism

Funding this study is part of the corresponding author's (EAS) doctoral programme of research funded by the University of Aberdeen, and supervised by EH and JC. Acknowledgements we thank all the students who took part in this project, and Professor Rona Patey, the Director of the Institute of Education for Medical and Dental Sciences, University of Aberdeen, for her support of this project.Peer reviewedPostprin

'Connecting tracks': exploring the roles of an Aboriginal women's cancer support network

Aboriginal Australians are at higher risk of developing certain types of cancer and, once diagnosed, they have poorer outcomes than their non-Aboriginal counterparts. Lower access to cancer screening programmes, deficiencies in treatment and cultural barriers contribute to poor outcomes. Additional logistical factors affecting those living in rural areas compound these barriers. Cancer support groups have positive effects on people affected by cancer; however, there is limited evidence on peer-support programmes for Aboriginal cancer patients in Australia. This paper explores the roles played by an Aboriginal women's cancer support network operating in a regional town in Western Australia. Data were collected through semi-structured interviews with 24 participants including Aboriginal and mainstream healthcare service providers, and network members and clients. Interviews were audiotaped and transcribed verbatim. Transcripts were subjected to inductive thematic analysis.Connecting and linking people and services was perceived as the main role of the network. This role had four distinct domains: (i) facilitating access to cancer services; (ii) fostering social interaction; (iii) providing a culturally safe space; and (iv) building relationships with other agencies. Other network roles included providing emotional and practical support, delivering health education and facilitating engagement in cancer screening initiatives. Despite the network's achievements, unresolved tensions around role definition negatively impacted on the working relationship between the network and mainstream service providers, and posed a threat to the network's sustainability. Different perspectives need to be acknowledged and addressed in order to build strong, effective partnerships between service providers and Aboriginal communities. Valuing and honouring the Aboriginal approaches and expertise, and adopting an intercultural approach are suggested as necessary to the way forward