Rigorously designed longitudinal studies can inform how best to reduce the widening health gap between Indigenous and non-Indigenous children. A systematic review was performed to identify and present the breadth and depth of longitudinal studies reporting the health and well-being of Indigenous children (aged 0–18 years) globally. Databases were searched up to 23 June 2020. Study characteristics were mapped according to domains of the life course model of health. Risk of bias was assessed using the National Institutes of Health (NIH) Study Quality Assessment Tools. Reported level of Indigenous involvement was also appraised; PROSPERO registration CRD42018089950. From 5545 citations, 380 eligible papers were included for analysis, representing 210 individual studies. Of these, 41% were located in Australia (n = 88), 22.8% in the USA (n = 42), 11.9% in Canada (n = 25) and 10.9% in New Zealand (n = 23). Research tended to focus on either health outcomes (50.9%) or health-risk exposures (43.8%); 55% of studies were graded as ‘good’ quality; and 89% of studies made at least one reference to the involvement of Indigenous peoples over the course of their research. We identified gaps in the longitudinal assessment of cultural factors influencing Indigenous child health at the macrosocial level, including connection to culture and country, intergenerational trauma, and racism or discrimination. Future longitudinal research needs to be conducted with strong Indigenous leadership and participation including holistic concepts of health. This is critical if we are to better understand the systematic factors driving health inequities experienced by Indigenous children globally.
12 May 2023 in Australian and New Zealand Journal of Public Health
This rapid review aims to identify how Indigenous research governance is conceptualised, implemented and documented within Australian Indigenous health research studies. We searched for peer-reviewed English-language articles in two databases and for web-based grey literature published from database inception to November 2021. Reference lists were searched to identify additional articles. Data relating to research governance were extracted and analysed thematically. A total of 1120 records were screened, and 27 articles were included. Most articles providing detailed description of Indigenous research governance activities were qualitative studies (n=15, 55.6%). Key themes included members are experts; respectful relationships; flexibility; and key logistic considerations (nuts 'n' bolts). Although Indigenous research governance is recognised as an essential part of ethical research, activities and contributions made by Indigenous reference group (IRG) members are underreported. This important work needs greater visibility in the published literature to share best practice in Indigenous research governance that foregrounds Indigenous expert knowledge, perspectives, and experiences. The study provides a synthesis of factors to consider when establishing and facilitating an IRG for research with Indigenous communities. This has implications for researchers who can adapt and apply the findings to their practice.
There is a need for quality longitudinal data on the health and well-being of young Aboriginal and Torres Strait Islander children (hereafter Aboriginal) in Alice Springs that can be used for research, planning and evaluation. The primary aim of this descriptive qualitative study was to determine whether or not a proposed cohort study would be acceptable to the local community. The proposed cohort study will prospectively examine various factors, events and exposures in early life that give Aboriginal children the best chance to grow up strong and lead a healthy happy life. Decisions on specific priority issues to be addressed and study procedures will be determined by local Aboriginal researchers and community members during a future co-design phase. 27 semi-structured interviews and 3 focus group discussions (FGD) were conducted with a range of community stakeholders and parents/caregivers of young Aboriginal children from Alice Springs in the Northern Territory (NT) of Australia. Audio recorded data were transcribed and imported into NVivo12 qualitative software for reflexive thematic analysis. Three major themes concerning acceptability of the concept were constructed from the analysis: (1) Have to be mindful, (2) Duplication of data, and (3) “It’s gotta be done right way”. There was general support for the concept, however, many participants felt that a cautious and slow approach was necessary. Recommendations included focusing on building trust, taking it slow, and ensuring the study is conducted by local Aboriginal researchers. Barriers to feasibility noted included the high mobility of families, competing demands, and privacy concerns. Findings from this qualitative study support the feasibility and acceptability of a future cohort study of young Aboriginal children in Alice Springs. Leadership from respected local Aboriginal researchers and key stakeholders will be critical to its success.
11 July 2024 in Australian Journal of Rural Health
Introduction: Many experts and communities have concerns about how National Disability Insurance Scheme services are provided to Aboriginal and Torres Strait children. This study was undertaken at the request of the NPY Women's Council in partnership with the researchers, to explore supports for Aboriginal and Torres Strait Islander children living with a disability in their remote areas.Objective: This scoping review aims to (a) explore the barriers and enablers to accessing disability support services for families of young Aboriginal and Torres Strait Islander children (0–8 years) living in regional, rural and remote settings, and (b) summarise best practice approaches for accessing support for young children in these settings.Design: The search was run in three electronic databases, as well as grey literature sources. We assessed the quality of included publications using the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange tool. A narrative synthesis was supported by thematic analysis.Findings: From an initial search (557 citations), we identified 13 eligible documents. Most documents were peer‐reviewed articles of qualitative studies. Key themes identified included the following: (1) Holistic approach, (2) Understanding disability, (3) Consistent relationships, (4), Flexibility, (5) Simplify system and (6) Enhance communication.Discussion/Conclusion: This scoping review has revealed gaps in the provision of quality, culturally responsive disability services for families of Aboriginal and Torres Strait Islander children living in regional, rural and remote areas of Australia. A family‐centred, flexible approach will help address their needs. Future research is required to design and evaluate models of care for Aboriginal and Torres Strait Islander children.