Academic literature on the topic 'Aboriginal women's health'

The Koorie Cultural Regeneration Project was the result of a partnership between Women's Health Goulburn North East and Mungabareena Aboriginal Corporation. The project was located in Wodonga and aimed to strengthen the community in terms of its Aboriginal identity. A range of activities provided opportunities for elders to share traditional skills and knowledge about Aboriginal culture particularly beliefs, men's business and women's business, dance and bush knowledge. A further dimension of the project was education of the mainstream community through presentations and workshops at schools, childcare centres, workplaces, festivals and universities. Immediate outcomes of the project included clear evidence of the power of experiential learning, a deepening understanding of culture, and the importance of story and connectedness. Eighteen months after the conclusion of the project, members of Mungabareena Aboriginal Corporation met with Women's Health Goulburn North East workers to reflect on the long term outcomes of the project. The value of cultural regeneration was affirmed and it was identified that the project raised the profile of the Koorie community in Wodonga and beyond. While the Koorie Cultural Regeneration Project has increased community understanding and pride in Aboriginal heritage and is working well, the lack of continued funding means it is not ongoing. The challenge now is to move forward with cultural regeneration with respect, integrity, care and wisdom.

Older women are more likely to live alone in poverty than others in the community. They are also likely to maintain their independence well into older life. Recent Australian research into women's health issues has not investigated older women's direct experiences associated with their medication use, or any related interactions with health professionals such as general practitioners, pharmacists or registered nurses. This is despite significant funding, policy and research in most other areas of women's health in the 1990s. Similarly, the medication experiences of older Aboriginal women have been neglected. This paper reports on a cohort of older Aboriginal women (N-10) from a recent South Australian qualitative study into medication use of diverse groups of older women (N-142). In-depth, semi-structured, face to face interviews were conducted, predominantly in participants' suburban homes, and in a community setting. Thematic analysis of the data was undertaken, and comparisons were made with other cohorts in the overall study. Results showed that the experiences and perspectives of the urban Aboriginal women highlighted their connectedness with family, services and community, and that this was largely due to their access to particular Aboriginal services, and to indigenous cultural affiliations and practices. Despite this connectedness, and regular contact with general practitioners and pharmacists, there were significant deficits in their knowledge and skills in managing their medication. It became clear that there is an urgent need for culturally safe medication information, education and support for older Aboriginal women. There is also an urgent need for better education, training and support of all health workers who have critical roles and responsibilities in assisting this group in the community.

This paper presents the findings regarding urban, predominantly young, Aboriginal women's experiences of patronising licensed premises in South Australia. This research aimed to tap new information directly from the experiences of participants who lived in the southern metropolitan region of South Australia. It focused on their experiences of socialising at licensed premises such as pubs and clubs, locally, and in the city of Adelaide. A qualitative research design within the critical social Scientific paradigm was applied using semi-structured interviews and thematic analysis. The recommendations developed from the findings, and the final community report, were developed collaboratively with participants and other Aboriginal women from their local community. Consistent with the experiences of other young non-Aboriginal women in South Australia, as reported by the chief investigator of this study, the findings of this research show that Aboriginal women try to enjoy socialising with friends and family in licensed premises such as pubs and clubs. However, the Aboriginal women were constrained by frequently experiencing racism and injustices when they tried to enter, or when inside, pubs and clubs. Being accused of stealing, prevented from entering or being expelled from venues, racist comments and being subjected to physical violence, conflict with bar and security staff and non-Aboriginal patrons, as well as lack of safety, were some of the issues these Aboriginal women have experienced in licensed premises in urban and suburban South Australia. This research now offers recommendations from the women that call for important changes in policy and service provision that can improve the conditions of Aboriginal women when they are visiting licensed premises.

When compared to other women in Australia Aboriginal women are considered the most socially and economically disadvantaged and have the poorest health status. Aboriginal women in Rockhampton, Central Queensland are not excluded from this lived reality. This research has explored Aboriginal women’s perceptions and experiences of health and health services in Rockhampton. Drawing on these experiences, and centring the voices of these women, the study reports on findings concerning cross-cultural issues, communication, policy, practice and service delivery. Importantly, the study has built new knowledge identifying the complex relationship between identity, body and well-being. In undertaking this study, I have developed a ‘talkin’ up’ research process in collaboration with other Aboriginal women. That is, by asking what Aboriginal women in Rockhampton wanted me as an Aboriginal woman researcher to explore and what type of process I would work through with Aboriginal women as the participants. The research has been informed and guided by these Aboriginal women and thus has witnessed the articulations of a more accurate portrayal of Aboriginal women’s perceptions and experiences of health services. I take the witnessing to be partly personally empowering, partly sharing and partly a taking of ownership of experience. As those women interviewed explained, our story here is told ‘by us’. In undertaking such a research process, I needed to ask what it means to be an Indigenous researcher and what is a good Indigenous research process? These are addressed at length within the thesis. This research process has not involved examining health services with regards to their service provision or their implementation of more empowering practices to improve health outcomes for Aboriginal women. This remains to be done. This research, has instead attempted to answer the question ‘how the relationship between health services and Aboriginal women can be more empowering from the viewpoints of Aboriginal women?’ The assumption underpinning this study is that empowering and re-empowering practices for Aboriginal women can lead to improved health outcomes. The study found : Aboriginal women had requirements of health services relating to cultural comfort of health service environments Aboriginal women did not access one health provider for all their health needs, they ‘shopped around’ to meet their general health, Women’s Business and relationship and privacy requirements Aboriginal women’s health is impacted upon by stereotypes held of Aboriginal women around skin colour and Aboriginality Aboriginal women have an understanding of what is required to improve the interactions between health service providers and Aboriginal women

This study addresses the self-identified health issues experienced by yorgas (women) in an Aboriginal Bindjareb (region) community in the Nyungar nation of south west Western Australia. In collaboration with yorga Elders and Leaders from the Murray Districts Aboriginal Association (MDAA), Caroline Nilson, a non-Indigenous researcher, academic and health professional, developed, coordinated, facilitated, and implemented a culturally appropriate health promotion initiative, the Bindjareb Yorgas Health Program [BYHP], which was the topic of Caroline's PhD research project. The BYHP aims were to foster the development of personal knowledge and skills in achieving and maintaining wellness, and the strengthening of community actions towards improving health by facilitating improved individual and group health literacy. Further, the study sought an understanding of the ways in which the BYHP facilitated healthy lifestyle change in the Bindjareb yorgas and their families and whether the structure and delivery of the program provided a supportive environment for the women to engage in sustainable health promotion activities. The BYHP was underpinned by the ideals of the Aboriginal model of health, which encompasses all aspects of a person's life (Lock, 2007). This concept places significant emphasis on social and emotional components and is linked to the sense of being Aboriginal, through connection with the environment (social and economic), community, relationships, land, the physical body and the mind, and traditional cultural lore (law) and knowledge (Nyungar kaartdijin). The BYHP study consisted of four components: nutrition and cooking classes, group fitness classes (including walking group sessions), a community vegetable garden project and health 'yarning' sessions (a culturally appropriate method of communicating about important matters), which comprised informal and formal discussions. Twenty-two women from the two kinship groups in two towns in the research setting were invited to take part in the project. Purposive and snowball sampling were used to recruit the yorga participants and the consent processes were conducted by the yorga Elders and Leaders and resulted in 17 Bindjareb yorgas consenting to participate. There were a total of 24 cooking and nutrition classes and all 17 participants each took part in between 3 and 22 classes. Attendance at the 33 group fitness classes varied, with 16 of the 17 participants taking part in between 1 and 29 classes; as did attendance at the 24 walking group sessions where 13 yorgas participated in between 3 and 22 sessions each. Six participants volunteered to share the vegetable garden management over a 24 week period resulting in an average weekly attendance of 5.5 visits between them. A number of yarning sessions (individual and group) were also facilitated by Caroline in collaboration with Karrie-Anne Kearing-Salmon, an Aboriginal woman Leader appointed as the research assistant. An ethnographic action research [EAR] approach was used in the research, which combines the methodologies of ethnography, participatory techniques and action research (Tacchi, Slater & Hearn, 2003; Tacchi, et al., 2007). The data was collected with the assistance of the yorga Elders and Leaders during which time Caroline was also mentored by Gloria Kearing, a yorga Elder. Data sources included audio recorded yarning groups, audio recorded individual yarning, direct observations and participant-observations, and Caroline's personal diary notes audio recorded during fieldwork. A narrative art project was also conducted as a culturally appropriate method of gathering data and was used as an opportunity to facilitate informal health yarning. The works of art were shared with the wider community in a public gallery exhibition, which ran for six weeks during August and September 2013. Thematic analysis of the data was undertaken in consultation and collaboration with the selected yorga Elders and Leaders for each component of the research, and was assisted using Artichoke ™ (Fetherston, 2013), a computer-based program. Results that have captured the main findings are presented in the thesis in a number of peer-reviewed published and under review articles and other manuscripts have been prepared and are in the process of submission. The themes identified from the cooking and nutrition component related to experiences of overwhelming loss, acknowledging collective shame, finding change too hard, being crippled by the lack of resources, mistrust, and tensions, community control empowering individuals through engagement, learning for life purpose, and planning for community determination. The themes derived from the group fitness component related to the loss of traditional knowledge and practices, withdrawal due to shame, community facilitation enabling enjoyment in engagement, and experiencing a sense of place and connection to land and culture. The community vegetable garden component themes related to feelings of ownership: "deadly, unna?" (very good, isn’t it?), "ngnaailak" (belongs to us); a sense of place: "nalaru boodjar" (our own country), "kwobbrup" (a good place); reconnection to traditional land: "boodjar, mundak and ponar" (land, the bush and the seasons); pride in learning new skills: "djinanginy kaartdijin" (seeing, learning, and understanding); and hoping for continued community engagement and partnership support: "patpatan mila" (worried for the future). The health yarning component themes related to patience in the ways of talking with the yorgas "moorditj bandjar tarwagin" (patient way of talking with us), feelings of safety to talk about health issues and coming together as equals to become strong in health; "djaliny moordidjabiny kootamiara quab" (listening to become strong in health). The narrative art project themes related to the overall connectedness and the mobilisation of community members in coming together to consolidate relationships for their health and wellbeing; individuals coming together for their health and wellbeing, and processes in mobilising community social relationships. The additional themes related to the yorgas developing self-identity through painting their experiences and their creativity contributing to community empowerment. In regards to sustainable lifestyle change, themes from the group fitness and cooking and nutrition components around the real challenges and barriers also emerged. The acknowledgement of shame was identified as a psychosocial barrier and previously experienced reduced health literacy was seen as having a negative impact on food security and healthy lifestyle choices. Several themes relating to the importance of a 'sense of place' and 'feelings of safety', and the 'rekindled connection to land' were threaded through all the components, particularly the vegetable garden project. These themes were critical in answering the research questions regarding community ownership and the culturally appropriate structure and delivery of the BYHP. Themes from the cooking and nutrition component also related to the impact of historical events on nutritional health of Indigenous Australians, and on the undermining effect of mistrust within the community and towards outsiders and the need to plan to achieve a real sense of community determination and address issues of limited resources. These themes were pertinent in answering the research question regarding the required community action to lead to the sustainability of the program. The findings suggest that historical colonisation processes greatly influence current Aboriginal health and wellbeing. It has impacted on individual and community esteem and determination, resulting in feelings of inadequacy, racial demoralisation and mistrust, towards others and within their own groups. Feelings of a sense of place, the reconnection to land and culture, and a sense of safety were a common thread to have emerged from the BYHP. These correlated with further findings that identify the need for community collaboration and control. The acknowledgement of shame was identified as a psychosocial barrier influencing health literacy, food security and healthy lifestyle choices. The real challenges of change around healthy eating and physical activity were highlighted, however the sense of purpose gained through learning new skills and knowledge was found to be a key driver towards change. To achieve sustainability the findings highlighted the need for continued partnership development and ongoing planning for skills and employment opportunity and these were identified as important to achieving a real sense of community determination.

The purpose of this master's thesis is to explore intersections within Aboriginal womens' descriptions of their experiences of accessing care in an urban context, and to explicate how service provider's perceptions of women's identity featured in their care encounters. This thesis is divided into three chapters. The first chapter provides a background on access to care for Aboriginal women living in urban contexts, outlines the methodology of the primary study, and explores the intersectionality paradigm used to complete the secondary analysis done for this study. The second chapter describes the results of the study. It begins by providing a general overview of the major themes and subthemes, followed by two manuscripts that have been written for submission for publication in scholarly journals. The third chapter discusses how this study has contributed to new knowledge for nursing, as well as the implications for nursing education, research and policy.

This collaborative qualitative research explored ways of improving Aboriginal women’s health and well-being in an urban Adelaide primary health care setting. This involved respectful knowledge sharing, working effectively together and addressing issues related to colonisation, discrimination and exclusion. It was identified that while Aboriginal and non-Aboriginal professionals are committed to ‘Closing the Gap’ in health disparities, many have questioned how best to do so within the current health system. Therefore, this research focused on filling gaps in knowledge about the spaces where Aboriginal community women, and Aboriginal and non Aboriginal health professionals can work collaboratively regardful and regardless of health system polices, programs and practices. A strong commitment to local community preferences and national Aboriginal health research ethics enabled Aboriginal community women and Aboriginal and non-Aboriginal heath professional co-researchers to be actively and meaningfully involved with me in both the research processes and outcomes. A modified Participatory Action Research (PAR), with repeated cycles of Look and Listen, Think and Discuss and Take Action emerged as an effective model of collaborative practice, suitable for health care and research. Four unique yet interconnected areas of collaboration developed, each highlighting particular aspects of culturally safe knowledge sharing and collaboration in health care. The first involved working with Aboriginal community women, acknowledging and addressing their most health and well-being priorities related to high levels of stress in their lives. Collaborative action involved creating a women’s friendship group, seeking and accessing a range of services, and co-presenting our findings at conferences The second Collaboration Area offers insights into the practicalities and difficulties experienced by staff as they tried to provide health services for Aboriginal women in a newly developing Aboriginal health organisation. The third Collaboration Area focused on the challenges and benefits of collaboration between sectors, in particular a local high school and the Aboriginal health service. We explored effective ways to work across sectors and engage young Aboriginal women in health programs. The ongoing impact of discrimination, exclusion and colonisation for this next generation of Aboriginal women was highlighted. The fourth Collaboration Area involved wider collaboration and road testing our collaborative methodology in a broader environment. A diverse group of co-researchers came together to plan, implement and evaluate a de-colonising national action research action learning conference embedded in Aboriginal preferred ways of knowing and doing. Findings are discussed under the three central themes of knowledge sharing, working together and addressing health care access and colonisation and key recommendations for the future are proposed. This research has reinforced the need identified in Aboriginal health documents for policy, program and practice commitment to holistic and collaborative approaches such as comprehensive primary health care and participatory action research. While the National Apology and Close the Gap campaign have provided opportunities for change, these need to be followed by tangible action at all levels of health care.

This qualitative research study focuses explicitly on understanding the experiences and perceptions of urban Aboriginal women living with HIV/AIDS. Stigmatizing attitudes and language have serious impacts upon the lives of HIV-positive Aboriginal women. The ways our society presently addresses the women needs to change. With the insights and assistance of four Aboriginal women living with HIV, this project adds to the presently sparse qualitative literature in this research area. Current research indicates that there are many factors associated with urban Aboriginal women being at higher risk for infection and lower physical and mental health, such as race, socio-economic conditions, isolation, oppression and violence, family history, substance abuse, discrimination, and often the responsibilities of childrearing. However, current research analysis and presentation is insufficient, and more in-depth questions arise. Material was collected using semi-structured, open-ended questioning conversations with the participants. Two guiding research questions were asked: 1) What is it like for you, living with HIV right now? and 2) What would you want other people to learn from your experiences? The women’s stories provide an avenue for participants to voice some of their triumphs and challenges about being an Aboriginal woman living with HIV/AIDS. For the community at large, this is also an opportunity to hear first hand, important information such as this. In this work, I have tried to adhere to the tenets of Indigenous methodologies by allowing the life-stories to resonate as holistic representations. Rather than deconstructing the women’s stories through naturalistic analysis (which continues to categorize and to objectify participants), the stories are viewed through a Health Narrative Topography whereby thematic genres such as Restitution, Chaos, and Quest are illuminated, while also being critically aware of some of the limitations to this framework. Three overarching themes are revealed through the women’s stories: 1) the empowerment and resiliency demonstrated by the participants; 2) the need for cultural competency in a society that continues to stigmatize Aboriginal and HIV-positive women; and, 3) the need for a more holistic approach within society when it comes to education, learning, and healing.

Aim: As a priority for Aboriginal women, in the context of worsening Aboriginal health and lack of clarity about successful strategies to address healthcare needs, this research explored successful strategies in remote Aboriginal women’s health that may be transferable to another community with similar health needs. Methodology: Against a background of cultural and historical events, the study sought to identify existing strategies and frameworks for Aboriginal women’s health. It uses Naturalistic Inquiry situated within the Interpretive paradigm and conceptualised within the philosophical approach of feminist and critical social theory It has examined Aboriginal health providers’ and women’s priorities, practices, perceptions and expectations within the context of primary health care and community development principles by Participatory Action Research (PAR). The successful elements of an established and effective Aboriginal Well Women’s Health (AWWH) program from Central Australia (CA) were identified, transferred and adapted to meet the needs of a willing recipient remote community in South Australia (SA). Working together with healthcare providers from CA and SA, the adapted Well Women’s Health program was implemented in an Aboriginal Community Controlled Health Service collaboratively with local mainstream Community Women’s health services and evaluated. Results: Over a two year period, the research was evaluated through Critical Social Theory examining both the process of implementation and the impact on the Aboriginal community, analysing both qualitative and quantitative data. The AWWH program model and its principles were successfully transferred, adapted and implemented in this community. The AWWH program which included comprehensive health screening, health information and lifestyle sessions have become core business of the Aboriginal health service and an Aboriginal Men’s Well Health program has also been established using the same model. The women have found the AWWH program culturally acceptable and their attendance has steadily increased and the program has reached those women in the community who previously had never experienced a well health check. It has also identified an extremely high incidence and comorbidity of acute illness and chronic disease in diabetes, renal and dental disease, mental and social health problems that require address. Conclusion: Health programs that are well established and effective can be successfully replicated, transferred and adapted to other communities if the elements that made them successful are acknowledged and those principles are then transferred with the program to a willing community with similar needs. This program transfer has potential to save much time and developmental costs that will help to address poor Aboriginal health.

Previous research, mostly on HIV-positive Aboriginal women (PAW) instead of with them, has focused primarily on their HIV-illness experience and the gaps and needs that arise from living with HIV. This has, arguably, allowed us to develop policies and programs to meet these needs; however, it has also contributed to dominant and disempowering representations of Aboriginal women living with HIV as troubled, vulnerable and in need of outside assistance. To counter-balance these negative representations and to co-create new strengths-based, culturally-relevant and gender-specific knowledge that can inform policies, programs and services for PAW, I partnered with PAW and Aboriginal community partners to develop a project that would provide PAW with an opportunity to tell a different kind of story about themselves than has previously been told by others. Using an Indigenist Intersectional Population Health framework that was underpinned by a strengths-based, arts-informed, culturally-grounded and decolonizing community-based participatory approach to research, we engaged 13 PAW across three sites (Toronto = 5; Montreal = 4; ‘Virtual’ group = 4) in individualized group research processes to better understand PAW’s perceptions of health instead of illness and the intersecting roles that culture and gender can play in supporting the self-defined health of PAW. We also engaged in innovative, culturally-relevant and participatory knowledge translation and exchange (KTE) and developed policy and practice recommendations from our research. Findings from Visioning Health suggest that PAW have a holistic and relational view of health that is grounded in their individual and collective identity as HIV-positive Aboriginal women. Health for PAW co-researchers has physical, mental, emotional and spiritual dimensions, and is fundamentally about ‘connecting’ and ‘feeling connected’ at multiple levels including self, others, community, culture, environment and Creator. Each of these levels is interrelated and each is grounded in Aboriginal cultures and ways of knowing that see all elements of the world as interconnected. This is consistent with previously published health concepts for Aboriginal peoples; however, this is the first articulation of PAW’s perspectives on health in the literature. PAW co-researchers also identified health-enabling strategies that they use to support their self-defined health, including understanding and resisting the broader context of colonization, reclaiming their voice and identity, creating safe spaces for themselves and their peers, and (re)connecting to Spirit. Given that the vast majority of policies and programs for PAW are based on Western concepts of health as predominantly physical, findings from this study can be used to inform strengths-based, culturally-relevant and gender-specific policies and practices that better fit the needs of PAW. One of the most significant and unexpected findings of our study, however, is that the process of participating in our research was, in itself, health enabling. Consistent with their perspectives on health, PAW co-researchers reported that participating in Visioning Health helped them feel connected to themselves, to others, to their communities, and to their cultures. PAW co-researchers also referred to their participation in Visioning Health as ‘a healing journey’ and ‘damn good medicine’. While we did not design our project as an ‘intervention’, it is clear that Visioning Health worked as a holistic and integrated action for social change on several levels that are mutually reinforcing. Policy and practice recommendations that flow from this research include: privileging PAW’s perspectives, grounding policy and practice in local Indigenous knowledges, highlighting PAW’s strengths instead of weaknesses, and incorporating a colonial analysis.

Background: Little is known about shared decision-making (SDM) interventions with Aboriginal Peoples. Purpose: To explore Aboriginal women’s SDM needs and engage Aboriginal women in culturally adapting an SDM approach. Methods: Three studies were guided by an advisory group, ethical framework and a postcolonial theoretical lens. 1. A systematic review of the literature to identify health decision-making interventions to support Indigenous Peoples. 2. An interpretive descriptive qualitative study using individual interviews with Aboriginal women to explore decision-making needs. 3. An interpretive descriptive qualitative study to culturally adapt and usability test the Ottawa Personal Decision Guide (OPDG) to support decision making by Aboriginal women. Results: 1. The only eligible intervention study was a randomized control trial conducted in the United States with 44 Indigenous students. Compared to baseline, post-intervention the students demonstrated increased knowledge and use of a four-step decision-making process. 2. Interviews with 13 Aboriginal women supported SDM. Shared decision-making needs were represented by four major themes and presented in a Medicine Wheel framework: To be an active participant; To feel safe with care; Engagement in the decision process; Personal beliefs and community values. Supports for each of the major themes focused on the relational nature of shared decision-making. 3. Aboriginal women participated in two focus groups (n=13) or usability interviews with decision coaching (n=6). For culturally adapting the OPDG seven themes were identified: “This paper makes it hard for me to show that I am capable of making decisions”; “I am responsible for my decisions”; “My past and current experiences affect the way I make decisions”; “People need to talk with people”; “I need to fully participate in making my decisions”; “I need to explore my decision in a meaningful way”; “I need respect for my traditional learning and communication style.” Conclusions: There is little evidence on SDM interventions with Indigenous Peoples. Although Aboriginal women support SDM, they may have unmet decision-making needs. The OPDG was culturally adapted to be combined with decision coaching and needs to be evaluated.

"When compared to other women Australia Aboriginal women are considered the most socially and economically disadvantaged and have the poorest health status. Aboriginal women in Rockhampton, Central Queensland are not excluded from this lived reality. This research has explored Aboriginal women's perceptions and experiences of health and health services in Rockhampton. Drawing on these experiences, and centring the voices of these women, the study reports on findings concerning cross-cultural issues, communication, policy, practice and service delivery. Importantly, the study has built new knowledge identifying the complex relationship between identity, body and well-being." -- abstract.