From Digital Mental Health to Digital Social and Emotional Wellbeing: How Indigenous Community-Based Participatory Research Influenced the Australian Government's Digital Mental Health Agenda.

This paper describes the first six years of a government-initiated project to train Indigenous health professionals in digital mental health (d-MH). It illustrates how community-based participatory research (CBPR) methods were used to enable this "top-down" project to be transformed into a 'ground-up' community-guided process; and how, in turn, the guidance from the local Indigenous community partners went on to influence the national government's d-MH agenda. The CBPR partnership between five community partners and a university rural health department is described, with illustrations of how CBPR harnessed the community's voice in making the project relevant to their wellbeing needs. The local Indigenous community's involvement led to a number of unexpected outcomes, which impacted locally and nationally. At an early stage, the conceptual framework of the project was changed from d-MH to the culturally-relevant Indigenous framework of digital social and emotional wellbeing (d-SEWB). This led to a significant expansion of the range and type of digital resources; and to other notable outcomes such as successful advocacy for an Aboriginal-specific online therapy program and for a dedicated "one-stop-shop" d-SEWB website, Wellmob, which was funded by the Australian government in 2019-2021. Some of the implications of this project for future Indigenous CBPR projects are discussed

BlackLivesMatter in Healthcare: Racism and Implications for Health Inequity among Aboriginal and Torres Strait Islander Peoples in Australia

Despite decades of evidence showing that institutional and interpersonal racism serve as significant barriers to accessible healthcare for Aboriginal and Torres Strait Islander Peoples, attempts to address this systemic problem still fall short. The social determinants of health are particularly poignant given the socio-political-economic history of invasion, colonisation, and subsequent entrenchment of racialised practices in the Australian healthcare landscape. Embedded within Euro-centric, bio-medical discourses, Western dominated healthcare processes can erase significant cultural and historical contexts and unwittingly reproduce unsafe practices. Put simply, if Black lives matter in healthcare, why do Aboriginal and Torres Strait Islander Peoples die younger and experience ‘epidemic’ levels of chronic diseases as compared to white Australians? To answer this, we utilise critical race perspectives to theorise this gap and to de-center whiteness as the normalised position of ‘doing’ healthcare. We draw on our diverse knowledges through a decolonised approach to promote a theoretical discussion that we contend can inform alternative ways of knowing, being, and doing in healthcare practice in Australia

Working with aboriginal communities to improve rural health

Program Keluarga Berencana (KB) merupakan Salah satu program untuk menurunkan angka kematian ibu dan menekan angka pertumbuhan penduduk. Pengertian MKJP(Metode kontra sepsi jangka panjang) adalah kontrasepsi yang dapat dipakai dalam jangka waktu lama, lebih dari dua tahun, efektif dan efisien untuk tujuan menjarangkan kelahiran lebih dari 3 tahun atau untuk mengakhiri kehamilan pada pasangan yang tidak mengingini tambah anak lagi. Tujuan dari penelitian ini adalah untuk mengetahui bagaimana pengaruh pemberian konseling KB oleh petugas lapangan keluarga berencana (PLKB) terhadap ibu dalam pemilihan metode kontrasepsi jangka panjang (MKJP) di Kelurahan Belawan Bahagia Tahun 2018. Penelitian ini termasuk penelitian studi analitik, dengan  jenis penelitian observasional dengan mencari pengaruh antar variable dan dilakukan analisis terhadap data yang dikumpulkan dan seberapa besar hubungan antar variable serta menggunakan data primer dan juga data sekunder. Penelitian ini menggunakan rancangan crosssectional sebagai rancangan penelitian. Populasi dalam penelitian ini adalah semua peserta KB aktif yang bertempat tinggal di Kelurahan Belawan Bahagia Kecamatan Medan Belawan Kota Madya Medan berjumlah 1245orang, kemudian dilakukan tehnik pengundian sampai didapat jumlah sampel 166 sampel. Hasil penelitian ditemukan bahwapemilihan materi dan media konseling yang baik, serta meode yang tepat mayoritas menggunakan Metode Kontrasepsi Jangka Panjang (MKJP). Ada pengaruh materi, media dan metode konseling terhadap MKJP dengan p.value <0,05

“You didn’t just consult community, you involved us”: transformation of a ‘top-down’ Aboriginal mental health project into a ‘bottom-up’ community-driven process

Objective: Recently, there has been a consistent call for Indigenous health research to be community-driven. However, for a variety of reasons, many projects, such as the one featured here, start as ‘top-down’. Using ten accepted principles for Aboriginal health research, the present article illustrates how a top-down project can be transformed into a ‘bottom-up’ community-driven project. Method: A table of examples is provided to show how the ten principles were translated into practice to create a bottom-up process. Results: We suggest that key elements for creating a bottom-up process are iterative conversations and community involvement that goes beyond notional engagement. A feature of community involvement is generating and sustaining ongoing conversations with multiple levels of community (organisations, health professionals, Elders, community members, project-specific groups) in a variety of different forums across the entire duration of a project. Local research teams, a commitment to building capacity in the local Indigenous workforce, and adequate timelines and funding are other factors that we hypothesise may contribute to successful outcomes. Conclusion: The article contributes to a much-needed evidence base demonstrating how appropriate structures and strategies may create bottom-up processes leading to successful outcomes

Diversity in eMental Health Practice: an exploratory qualitative study of Aboriginal and Torres Strait Islander service providers

Background: In Australia, mental health services are undergoing major systemic reform with eMental Health (eMH) embedded in proposed service models for all but those with severe mental illness. Aboriginal and Torres Strait Islander service providers have been targeted as a national priority for training and implementation of eMH into service delivery. Implementation studies on technology uptake in health workforces identify complex and interconnected variables that influence how individual practitioners integrate new technologies into their practice. To date there are only two implementation studies that focus on eMH and Aboriginal and Torres Strait Islander service providers. They suggest that the implementation of eMH in the context of Aboriginal and Torres Strait Islander populations may be different from the implementation of eMH with allied health professionals and mainstream health services. Objective: The objective of this study is to investigate how Aboriginal and Torres Strait Islander service providers in one regional area of Australia used eMH resources in their practice following an eMH training program and to determine what types of eMH resources they used. Methods: Individual semistructured qualitative interviews were conducted with a purposive sample of 16 Aboriginal and Torres Strait Islander service providers. Interviews were co-conducted by one indigenous and one non-indigenous interviewer. A sample of transcripts were coded and thematically analyzed by each interviewer and then peer reviewed. Consensus codes were then applied to all transcripts and themes identified. Results: It was found that 9 of the 16 service providers were implementing eMH resources into their routine practice. The findings demonstrate that participants used eMH resources for supporting social inclusion, informing and educating, assessment, case planning and management, referral, responding to crises, and self and family care. They chose a variety of types of eMH resources to use with their clients, both culturally specific and mainstream. While they referred clients to online treatment programs, they used only eMH resources designed for mobile devices in their face-to-face contact with clients. Conclusions: This paper provides Aboriginal and Torres Strait islander service providers and the eMH field with findings that may inform and guide the implementation of eMH resources. It may help policy developers locate this workforce within broader service provision planning for eMH. The findings could, with adaptation, have wider application to other workforces who work with Aboriginal and Torres Strait Islander clients. The findings highlight the importance of identifying and addressing the particular needs of minority groups for eMH services and resources

R u appy? An opportunity for health professionals to try out Aboriginal-specific e-social and emotional wellbeing apps

As part of the national e-mental health initiative, the Federal Department of Health and Ageing has funded the University Centre for Rural Health (North Coast) and the Menzies School of Health Research to train Aboriginal health professionals in the use of e-social and emotional wellbeing technologies including apps for smartphones and tablets and online mental health programs. This project will be rolled out across the North Coast and the Northern Territory in 2014 and 2015. The aim is to train Aboriginal and Torres Strait Islander health and community professionals, and others who work with Aboriginal and Torres Strait Islander clients to develop skills and confidence in using new technologies as an additional tool to assist their clients. This workshop will provide an opportunity for health professionals to experience two of the Aboriginal-specific apps which have been developed for clients: Stay Strong and Ibobbly. Participants will be introduced to the apps and have the opportunity to try them out for themselves on iPads or Tablets provided in the workshop. During 2015, a full training and supervision program will be offered to health and community professionals in northern NSW. Please note that this workshop does not constitute a training program – rather it is designed as a little ‘taster’ of the apps! Numbers of participants will be limited by the number of iPads and Tablets available