Family support programs: ensuring a healthy start to life

This report details the findings of a targeted literature review and discussions in England and New Zealand with researchers and service delivery personnel involved in family support and parent education programs.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy

Getting it Right: study protocol to determine the diagnostic accuracy of a culturally-specific measure to screen for depression in Aboriginal and/or Torres Strait Islander people

Abstract Introduction: A freely available, culturally valid depression screening tool is required for use by primary care services across Australia to screen for depression in Aboriginal and/or Torres Strait Islander populations. This is the protocol for a study aiming to determine the validity, sensitivity and specificity of the culturally adapted 9-item Patient Health Questionnaire (aPHQ-9). Methods and analysis: Cross sectional validation study. A total of 500 people who self-identify as Aboriginal and/or Torres Strait Islander, are ≥ 18 years of age, attending one of 10 primary health care services or service events across Australia and able to communicate sufficiently to answer study questions will be recruited. All participants will complete the aPHQ-9 and the criterion standard MINI International Neuropsychiatric Interview (MINI) 6.0.0. The primary outcome is criterion validity of the aPHQ-9. Process outcomes related to acceptability and feasibility of the aPHQ-9 will be analysed only if the measure is found to be valid. Ethics and dissemination: Lead ethical approval was obtained jointly from the University of Sydney Human Research Ethics Committee (project 2014/361) and the Aboriginal Health and Medical Research Council of New South Wales (project 1044/14). Results will be disseminated via the usual scientific forums including peer-reviewed publications and presentations at international conferences following presentation to, discussion with and approval by participating primary health care service staff and community. Study registration number: ACTRN1261400070568

The availability, appropriateness, and integration of services to promote Indigenous Australian youth wellbeing and mental health : Indigenous youth and service provider perspectives

Concerns about the complexity, fragmentation and inefficiency of Australia’s current youth mental health service systems have led policy makers to seek improvements through a shift to community-based solutions. However, there is little evidence of how communities can make this shift. This paper examines the efforts of one Aboriginal and Torres Strait Islander (hereafter, respectfully, Indigenous) community—Yarrabah in north Queensland—to develop strategies for mental health and wellbeing service system improvements for school-aged youth (5–18 years). The research was co-designed with Yarrabah’s community-controlled health service and explores the perceptions of Yarrabah youth and service providers. Iterative grounded theory methods were used to collect and analyse data from 32 youth aged 11–24 years and 24 service providers. Youth were reluctant to seek help, and did so only if they felt a sense of safety, trust, relationality and consistency with providers. Young people’s four suggestions for improvement were access to (1) information and awareness about mental health; (2) youth facilities, spaces and activities; (3) safe and available points of contact; and (4) support for recovery from mental illness. Service providers highlighted an appetite for youth-guided community change and recommended five improvement strategies: (1) listening to youth, (2) linking with community members, (3) providing wellbeing promotion programs, (4) intervening early, and (5) advocating to address the determinants of youth mental health. Overall, both groups realised a disjunct between youth need and service provision, but a willingness to work together for systems change. This study demonstrates the importance of community-driven efforts that harness both youth and service providers’ perspectives, and suggests a need for ongoing dialogue as the basis for co-designing and implementing improvements to wellbeing supports and mental health services for Indigenous youth

Moving beyond the front line: a 20-year retrospective cohort study of career trajectories from the Indigenous Health Program at the University of Queensland

This report examines critical success factors for enabling Aboriginal and Torres Strait Islander leadership across the health system as demonstrated by alumni of the University of Queensland (UQ) Indigenous Health Program (IHP) (1994–2005) who today work in various leadership roles throughout the country.\ua0It determines the enablers of professional success of these health leaders in various facets of the health system and investigates the impact of active participation in the community of Aboriginal and Torres Strait Islander health professionals over the course of a career. Through this analysis, the report further theorises the confluence of community, subjectivity, self-determination and health

Weighing Every Day Matters: Daily Weighing Improves Weight Loss and Adoption of Weight Control Behaviors

Daily weighing is emerging as the recommended self-weighing frequency for weight loss. This is likely because it improves adoption of weight control behaviors

Interventions for Bowen's Disease

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of therapeutic interventions for Bowen's disease

The impact of interventions to prevent obesity or improve obesity related behaviours in children (0-5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review

BackgroundChildren from disadvantaged families including those from low socioeconomic backgrounds and Indigenous families have higher rates of obesity, making early intervention a priority. The aim of this study was to systematically review the literature to examine the effectiveness of interventions to prevent obesity or improve obesity related behaviours in children 0-5 years from socioeconomically disadvantaged or Indigenous families.MethodsSearches of major electronic databases identified articles published from 1993–2013 targeting feeding practices, anthropometric, diet, activity or sedentary behaviour outcomes. This was supplemented with snowballing from existing reviews and primary studies. Data extraction was undertaken by one author and cross checked by another. Quality assessments included both internal and external validity.ResultsThirty-two studies were identified, with only two (both low quality) in Indigenous groups. Fourteen studies had a primary aim to prevent obesity. Mean differences between intervention and control groups ranged from -0.29 kg/m2 to -0.54 kg/m2 for body mass index (BMI) and -2.9 to -25.6% for the prevalence of overweight/obesity. Interventions initiated in infancy (under two years) had a positive impact on obesity related behaviours (e.g. diet quality) but few measured the longer-term impact on healthy weight gain. Findings amongst pre-schoolers (3–5 years) were mixed, with the more successful interventions requiring high levels of parental engagement, use of behaviour change techniques, a focus on skill building and links to community resources. Less than 10% of studies were high quality. Future studies should focus on improving study quality, including follow-up of longer-term anthropometric outcomes, assessments of cost effectiveness, acceptability in target populations and potential for implementation in routine service delivery.ConclusionThere is an urgent need for further research on effective obesity prevention interventions for Indigenous children. The findings from the growing body of intervention research focusing on obesity prevention amongst young children from socioeconomically disadvantaged families suggest intervention effects are modest but promising. Further high quality studies with longer term follow up are required

Aboriginal and Torres Strait Islander oral health and its impact among adults: a cross-sectional study

Robust oral health epidemiological information for Aboriginal and Torres Strait Islander adults is scant. Set within a large urban population, this study describes self-reported oral health behaviours, status and impact assessed through computerized health checks (HC), stratified by age groups and sex, and identifies associations with dental appearance satisfaction.This was a cross-sectional study of Aboriginal and Torres Strait Islander adults (aged ≥20\ua0years) attending the Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care between 1\ua0January 2014 and 31\ua0December 2015 who had HC and provided research consent.There were 945 patients, 466 (49.3%) female, with an average age of 41.3\ua0years (range, 20-82). Overall, 97.3% owned a toothbrush and 56.2% brushed two or more times/day. Despite self-reporting a significant oral health burden, only 28.8% visited a dentist within 12\ua0months, mostly due to problems (84.3%). Surprisingly, only 28.4% reported dental appearance dissatisfaction, likely a result of community normalization whereby people are resigned to poor oral health.Under-utilization of dental services remains problematic for Aboriginal and Torres Strait Islander adults. To close the oral heath gap, culturally appropriate, acceptable and safe integrated primary health systems, with co-located dental services, demand consideration