Dissertations / Theses on the topic 'Aboriginal women's health'

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.

This article explores the partnership between Aboriginal women researchers (associated with the AKRN) and Aboriginal women healers versed in holistic and culturally appropriate healing techniques. The development of this partnership will be highlighted to demonstrate a respectful research process that utilizes best practice such as identified within the Canadian Institute of Health Research (CIHR) – Guidelines for Research with Aboriginal Peoples. The primary goal of the AKRN is to provide up to date and relevant research that focuses on Aboriginal women’s health as well as to build research capacity and knowledge transfer.

This study tells the stories of 16 Aboriginal women of how they promote their health, as well as the health of their families and communities. There is a focus on the definition of health using a medicine wheel depiction and the determinants of health that are currently recognized by Health Canada. Four additional determinants were identified by the women in this study and a discussion regarding each is included. This study was viewed through a feminist lens. The qualitative method used was women-centred interviewing of a convenience sample of 16 Aboriginal women residing in rural Manitoba. Content analysis of the verbatim transcripts revealed the following themes and sub-themes: health defined- lifestyle choices; physical, emotional, intellectual and spiritual health; healthy self; 1 need to be me - the importance of self care - promoting my health; having faith; hopes and dreams; barriers to being healthy - shame; racism; addiction; domestic violence; abuse; teenage pregnancy; poverty; promoting health in my family - healthy family; taking care of my children; perceived social supports; and promoting health in my community, it takes a community to raise a child - healthy community; strong leadership; employment, housing, education and safety; and lack of available services. The categories are identified in Health Canada's determinants of health with the exception of: faith, social equality, healthy partner relationships and strong community leadership. Implications for nursing education and practice, policy and research are discussed. There are 10 recommendations for future consideration.

碩士
國立臺東大學
體育教學碩士在職專班
97
The objective of this study was to examine the different self perceived health status and health-promoting lifestyles among middle age aboriginal women, and discuss the relationships of exercise phase distribution, default variables, and self perceived health status with health promoting lifestyles utilizing exercise phase, self-perceived health status, and health-promoting lifestyle tables. A total of 105 middle age aboriginal women at age of between 30 and 54 living in the towns of Daren and Jinfong in the Daiwu area of Taitung County were randomly sampled through a questionnaire survey. The results were analyzed in use of various methods such as goodness-of-fit test, one-way ANOVA, Pearson’s product-moment correlation, LSD method, and multivariate regression analysis. All significance level  values is set for .05. The results are as follows: 1.The number of contemplation in the exercise phase table is greatest followed by precontemplation, preparation, maintenance, and then action. 2.The survey results on potential sickness indicate that: the aboriginal women between age group 30 through 39 and 40 through 49 had more potential to get sick than the ones at age 50 through 54; the aboriginal women with middle school degree had more potential to get sick than the ones with elementary and senior high school or higher degrees. Results on current health status show that the women with high school degrees felt healthier than the ones with elementary school degrees. Results on comparisons with any acquaintances indicate that women with one child or no children and three children felt healthier than the ones with two children. 3.In the six factors accounted for affecting the health-promoting lifestyle, the nutrition had most significant effect on the health promoting lifestyle, followed by association support, self accomplishment, stress management, health responsibility, and exercise. Aboriginal woman with high school degrees or higher did better in self accomplishment and nutrition than the ones with elementary school degrees. For the women with annual income of equal to and less than 20,000, they did not perform better than the ones with 21,000 through 40,000 and 41,000 through 60,000 incomes. 4.In the self-perceived health status, current health status, health deterioration, and wellness had a correlation with nutrition amount; potential to get sick had correlation with self accomplishment, nutrition, association support, and stress management. 5.The four predictors of health-promoting lifestyle: precontemplation and maintenance, preparation and maintenance in the exercise phase distribution, annual household income equal to and less than 20,000 and greater than 60,000, potential to get sick in the self perceived status, indicate 35.4% variance of health-promoting lifestyle.

Research Doctorate - Doctor of Philosophy (PhD)
Aboriginal Australians have high rates of many chronic diseases, the causes of which are multi-factorial. Optimal nutrition throughout life is protective against a number of adverse health outcomes, and can begin with setting the scene for lifelong health in utero and in the first years of life. However, little is currently known about the dietary intakes of Aboriginal Australian women in pregnancy and in the postpartum period, and their children, particularly in early infancy. This thesis by publication is presented as a series of published research articles. Specific research aims and the results of studies arising from this thesis are summarised below. Dietitians are well-placed to support and work alongside Aboriginal communities in developing and supporting strategies to optimise nutrition for Aboriginal woman and children. Dietitians must demonstrate cultural competency, however opportunities for practical experiences working with Aboriginal communities are limited during undergraduate nutrition degree programs. The aim of the first study was to evaluate the cultural awareness experiences of student and new-graduate dietitians working in an Aboriginal ArtsHealth setting. Six participants reported on their experiences through either written feedback (via email) or oral feedback (via semi-structured interview). A generic inductive approach was used for qualitative data analysis. Key themes emerged around ‘building rapport’ and ‘developing cultural understanding’. Some participants reported an increased understanding of the context around health disparity for Aboriginal Australians, and the experiences of the student and new-graduate dietitians were overwhelmingly positive. To optimise nutrition, current nutrition practices and dietary intakes need to be quantified. The second study of this thesis reports on the dietary intakes and anthropometric and body composition measures of a sample of women and their infants from the Gomeroi gaaynggal study, a prospective longitudinal cohort of Aboriginal women and their children in regional NSW from pregnancy to five years postpartum. A cross-sectional analysis of n=73 mother-child dyads from three months to five years postpartum found a breastfeeding initiation rate of 85.9%, with a median (interquartile range [IQR]) duration of 1.4 months (0.5 – 4.0). Introduction of infants to solid foods and cow’s milk were at 5.0 months (4.0–6.0) and 12.0 months (10.0–13.0) respectively. At one year postpartum 66.7% of women were overweight or obese, and 63.7% were overweight or obese at 2 years postpartum. Results from the Gomeroi gaaynggal cohort were preliminary, but suggest that women in this cohort may benefit from further support to optimise nutrition for themselves and their children. Providing women with tailored nutrition advice requires appropriate tools for dietary assessment. Image-based dietary records are emerging as a novel method for dietary assessment that limits some of the participant burden associated with traditional methods of dietary assessment. The Diet Bytes and Baby Bumps study used image-based dietary records captured via smartphones and a purpose-built brief tool (the Selected Nutrient and Diet Quality [SNaQ] tool) to assess nutrient and food group intakes of pregnant women and to inform the delivery of tailored nutrition advice to participants during their pregnancy. Twenty-five women (27 recruited, including 8 Aboriginal Australians, one withdrawn, one incomplete), had image-based records appropriate for analysis. Median intakes of core food groups of grains and cereals, vegetables, fruit, meat and dairy were reported as being below recommendations, but intakes of energy-dense, nutrient-poor foods exceeded recommendations. Cohen kappa showed moderate to substantial agreement between the SNaQ tool and the nutrient analysis software when assessing adequacy of micronutrient intakes. Relative validity was established by comparison of the image-based dietary records and 24-hour food recalls. There were significant correlations between the two methods of dietary assessment for energy, macronutrients and micronutrient intakes (r=.40–.94, all P<.05), with acceptable agreement between methods. Seventeen women reported changing their diets as a result of receiving personalised nutrition advice. The DietBytes method of image-based dietary assessment was well-received, with 88% of participants stating they would use the method again, including all Aboriginal participants. A systematic review was conducted to identify existing programs that have aimed to improve nutrition-related outcomes in Indigenous pregnant women worldwide, and to identify positive factors contributing to successful programs. This review consisted of 27 studies (20 programs) from Australia, Canada, and the United States of America; the most prevalent outcome measures were breastfeeding initiation/duration (n=11 programs) and birth weight (n=9 programs). Activities employed within programs that resulted in statistically significant improvements in health and/or nutrition outcomes included individual counselling and education, and involvement of peer counsellors or other Indigenous program staff. In successful programs, emphasis was placed on designing nutrition interventions in collaboration with Indigenous communities. This research thesis has highlighted key areas for improving dietary intake and nutrition-related health of Aboriginal Australian women and their children, including breastfeeding duration, appropriate timing of introduction to solid food and cow’s milk, nutrient and food group intake of pregnant and postpartum women, and improving rates of overweight and obesity in women postpartum. An image-based dietary record method of dietary assessment has demonstrated relative validity and acceptability for dietary assessment of Aboriginal pregnant women and acceptability to guide nutrition counselling. Dietitians can best support Aboriginal women and children by working in collaboration with communities to optimise nutrition, and support practice-based student experiences during university training where possible to assist in development of cultural competency skills.

碩士
國立陽明大學
臨床護理研究所
94
Objective. The objective of this study was to examine the health-promoting lifestyles and their relationships with health status, health concepts, and social acculturation among urban aboriginal women in Taipei. Methods. Aboriginal women who lived in the Beitou District of Taipei were interviewed with a structured questionnaire, including demographic information, health status, social acculturation, health concepts, and health-promoting lifestyles. The relationship between health-promoting lifestyles and other health-related characteristics were analyzed by ANOVA, Pearson ‘s correlation, and stepwise multivariate linear regression method. Results. A total of 169 aboriginal women completed the questionnaire survey. The standardized health status score was highest in physical functioning and lowest in vitality. The study women’s score in physical health was better than in mental health. This population had a moderate level of social acculturation; and a diverse but positive health concept. Multivariate linear regression analysis revealed that “vitality”, “frequency of church attendance”, and “physical functioning” were independently and positively associated with health-promoting lifestyles. Conclusion. These findings are important for nurses to develop health-promotion interventions for urban aboriginal women.

Research Doctorate - Doctor of Philosophy (PhD)
Globally, tobacco use is the leading cause of morbidity and mortality, causing an annual death rate of seven million people. In Australia, tobacco use is responsible for 9% of the total burden of disease. Smoking during pregnancy remains a significant public health problem for specific population groups, causing miscarriage, stillbirth, low birth weight and more. Psychosocial interventions such as behavioural counselling have been shown to be effective. Clinical guidelines in Australia recommend using the 5As approach: Ask about smoking status, Advise briefly to quit, Assess nicotine dependence and motivation to quit, Assist as needed (including behavioural counselling and nicotine replacement therapy [NRT] if required), and Arrange follow-up and referral to smoking cessation support services. NRT is recommended if the woman is unable to quit using only behavioural counselling, with oral NRT considered as first line. Aboriginal and Torres Strait Islander pregnant women have the highest smoking rates in Australia at 43%, facing multiple barriers to quitting smoking, including lack of adequate support from health providers. Health providers also face many barriers to support pregnant women to quit smoking, on an individual and systematic organisational level. To date, very few interventions have tried to improve health providers’ management of smoking with Aboriginal and Torres Strait Islander pregnant women. Those that have either did not use rigorous research methods or suffered from multiple implementation challenges. The aim of this thesis was to explore health providers’ practices regarding smoking cessation care during pregnancy, barriers to the provision of smoking cessation care and methods for improving health providers’ care, and to test an evidence-based behaviour change intervention to improve health providers’ provision of smoking cessation care to pregnant Aboriginal and Torres Strait Islander women. Papers one to five explore health providers’ provision of smoking cessation care during pregnancy in general. Some data for Aboriginal and Torres Strait Islander pregnant women who smoke is also presented. The results of the first five studies were used to refine the development of a multi-component pilot intervention: the Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy intervention for implementation in Aboriginal medical services. Papers six to eight explore the development of the intervention resources, the intervention protocol and the effect of this intervention on health providers’ smoking cessation care. Three related theoretical frameworks were drawn on throughout the research: the Theoretical Domains Framework (TDF), Behaviour Change Wheel (BCW) and the COM-B (Capability, Opportunity, Motivation–Behaviour) model for behaviour change. Paper one, “Opportunities Missed: A Cross-Sectional Survey of the Provision of Smoking Cessation Care to Pregnant Women by Australian General Practitioners and Obstetricians”, presents the results of a national cross-sectional survey of 378 general practitioners (GPs) and obstetricians about their knowledge, attitudes and practices providing smoking cessation care to pregnant women. Data from this survey revealed low levels of provision of several smoking cessation care components (“Assess”, “Assist” and “Arrange”), with only 15.6% of GPs and obstetricians reporting “often and/or always” performing all of the recommended 5As. Specifically, GPs and obstetricians reported that they lacked time, resources and confidence in their ability to prescribe NRT during pregnancy, and lacked optimism that their intervention would be effective. Paper two, “Clinician Factors Associated with Prescribing Nicotine Replacement Therapy in Pregnancy: A Cross-Sectional Survey of Australian Obstetricians and General Practitioners”, reports the results from the same cross-sectional survey mentioned in paper one, exploring GPs’ and obstetricians’ NRT prescribing rates and factors that might influence this. Overall, 25% of GPs and obstetricians reported “never” prescribing NRT, with nearly 50% reporting they would “never” prescribe combination NRT (NRT patch plus an oral NRT). GPs had higher odds of prescribing NRT compared to obstetricians. Other factors that significantly increased the odds of NRT prescription were reading the Royal Australian College of General Practitioners (RACGP) guidelines, confidence in their ability to prescribe NRT and viewing NRT as safe, effective and with good patient adherence. Paper three, “Overcoming Challenges to Treating Smoking during Pregnancy – A Qualitative Analysis of Australian General Practitioners’ Barriers and Facilitators”, reports on semi-structured qualitative interviews that were conducted with 19 GPs, aiming to explore their management of smoking during pregnancy in greater depth and what would enable them to improve their smoking cessation support to pregnant women. GPs were recruited from the cross-sectional survey participants and from those attending a national GP conference. Participants reported they lacked communication skills to provide pregnant patients adequate support for quitting, focusing on providing information on smoking harms and discussing treatment options only with patients who reported an interest in quitting. Lack of time, NRT cost, previous negative experiences with NRT and safety concerns, being unfamiliar with the Quitline process and uncertainty over its suitability (specifically for Aboriginal and Torres Strait Islander peoples) were all perceived as additional challenges. Participants reported needing clear detailed guidelines, with visual resources they could use to discuss treatment options with patients. Paper four, “Nicotine Replacement Therapy for Smoking Cessation in Pregnancy – A Narrative Review”, provides an overview of the current guidelines regarding NRT use in pregnancy, while considering the existing evidence base on NRT safety, efficacy and effectiveness during pregnancy. Animal models show that nicotine is harmful to the foetus, especially for brain and lung development, but human studies have not found any harmful effects on foetal and pregnancy outcomes. Previous studies have used NRT doses that might have been too low and not have adequately accounted for the higher nicotine metabolism during pregnancy, and thus not sufficiently treating withdrawal symptoms. Nonetheless, studies of efficacy and effectiveness in the real world suggest that NRT use during pregnancy increases smoking cessation rates. Current national clinical guidelines from Australia, the United Kingdom, New Zealand and Canada recommend that if women are unable to quit smoking with behavioural interventions alone, they should be offered NRT in addition to behavioural counselling. The guidelines also impose many restrictions on NRT prescription during pregnancy and do not provide practical detailed guidance on when to initiate NRT and how to titrate the dosage. Pragmatic suggestions for clinical practice are made, including an approach for initiating and titrating NRT dosage during pregnancy and for discussing the risks versus benefits of using NRT in pregnancy with the pregnant patient and her partner. Paper five, “Improving Health Providers’ Smoking Cessation Care in Pregnancy: A Systematic Review and Meta-Analysis”, reviews the data from all published interventions aimed to improve health providers’ smoking cessation care during pregnancy. To be included, the intervention studies needed to collect data on the health providers’ performance. Overall, 16 studies describing 14 interventions were included – 10 used a quasi-experimental design (pre–post), with only six studies using a randomised controlled trial (RCT) design. Using the Cochrane Effective Practice of Care (EPOC) taxonomy of intervention components, the review found that the median number of intervention components reported by studies was two (range 1–6). The most common intervention components used were training (93%, n=13), educational resources (64%, n=9) and reminders (57%, n=8). Studies used a variety of outcome measures, with different data collection methods (such as self-report through survey, women’s report on the health providers’ care, audit of medical records or recordings of medical consultations), affecting the ability to synthesise the data. Specifically, the “Assist” or “Provide smoking cessation support” component of care was ill defined with vast variability between studies. Meta-analysis of the different smoking cessation care components (according to the 5As) showed a small significant increase in the provision of all smoking cessation care components. The review suggests that use of a behaviour change theory to guide intervention development, and inclusion of audit and feedback, increases the likelihood of intervention effectiveness in improving health providers’ provision of certain smoking cessation care components. Paper six, “Assessing and Validating an Educational Resource Package for Health Professionals to Improve Smoking Cessation Care in Aboriginal and Torres Strait Islander Pregnant Women”, describes a multi-centre community-based participatory research study. This study aimed to assess a collaboratively developed educational resource package to aid health providers’ smoking cessation care in pregnant Aboriginal and Torres Strait Islander women. A panel of eight experts with complementary expertise provided input and suggestions to aid simplicity and usefulness of the resources. Staff members from three Aboriginal medical services in New South Wales (NSW), Queensland (Qld) and South Australia (SA) scored each of the patients’ resources using the “Suitability of Material” scoring method, finding that all received adequate or superior scoring. Average readability was grade 6.4 for patient resources (range 5.1–7.2; equivalent to ages 10–13 years) and 9.8 for health provider resources (range 8.5–10.6; equivalent to ages 13–16 years). Content analysis from focus groups with health providers from the three Aboriginal medical services revealed four themes including “Getting the message right”, “Engaging with family”, “Needing visual aids” and “Requiring practicality under a tight timeframe”. Results were presented back to a Stakeholder and Consumer Aboriginal Advisory Panel (SCAAP), and resources were adjusted accordingly for inclusion in the ICAN QUIT in Pregnancy multi-component intervention. Paper seven, “The Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy Pilot Study Protocol: A Feasibility Step-Wedge Cluster Randomized Trial to Improve Health Providers’ Management of Smoking during Pregnancy”, describes the protocol of a step-wedge cluster randomised pilot study: the ICAN QUIT in Pregnancy intervention. This protocol described an intervention aiming to improve health providers’ provision of evidence-based, culturally responsive smoking cessation care to pregnant Aboriginal and Torres Strait Islander smokers. Six Aboriginal medical services were randomised into three clusters for implementation. Clusters received the intervention staggered by one month. The intervention included a three-hour training webinar for health providers, educational resource packages for health providers and pregnant women, free oral NRT for pregnant women and audit and feedback on health providers’ performance. Health providers would complete a cross-sectional survey pre training and post training. Health providers’ outcomes would include changes in self-reported knowledge, attitudes and practices after receiving the intervention. Paper eight, “Improving Smoking Cessation Care in Pregnancy at Aboriginal Medical Services: ICAN QUIT in Pregnancy Step-Wedge Cluster Randomized Pilot Study”, presents the pilot study outcomes of changes in health providers’ knowledge, attitudes and practices. Of 93 eligible health providers, 50 consented to the trial (54%), 45 completed the pre-intervention survey (90%) and 20 completed the post-intervention survey (40%). About 42% (n=39) of health providers participated in the webinar training. Health providers’ knowledge was measured using two composite scores – one calculated using all 24 true/false statements and the other derived from 12 NRT-specific statements. Mean knowledge composite scores improved significantly from pre to post (78% vs 84% correct, p=0.011). The mean NRT-specific knowledge composite score also improved significantly (68% vs 79% correct, p=0.004). Self-assessment of 24 attitudes to providing smoking cessation care was measured using a 5-point Likert scale (Strongly Disagree to Strongly Agree). Two composite mean scores were calculated –one for 15 general smoking cessation care attitudes and the other for seven NRT-specific attitudes. The mean attitude composite score improved significantly (3.65 [SD 0.4] to 3.87 [SD 0.4]; p=0.017). The mean NRT-specific attitudes composite score also improved significantly (3.37 [SD 0.6] to 3.64 [SD 0.7]; p=0.005). Self-reported provision of smoking cessation care components was measured on a 5-point Likert scale (Never to Always); none of the practices improved significantly, including the prescribing of NRT. In summary, increasing health providers’ provision of smoking cessation care to pregnant Aboriginal and Torres Strait Islander women is a significant priority in Australia. This body of work highlights that currently, health providers are lacking in their provision of smoking cessation care, specifically in their support for pregnant Aboriginal and Torres Strait Islander women to quit smoking. Particularly, the provision of the “Assist” smoking cessation component was low, including the prescription of NRT. Multiple barriers exist and include lack of knowledge, skills (especially communication skills), time, resources and lack of optimism. Guidelines do not provide clear guidance, including the optimal timing for initiating NRT and titrating the dosage. The pilot intervention tested within this thesis showed promising initial results, with health providers significantly improving their knowledge and attitudes, although this did not translate into improved practices. Several strategies might enhance the effectiveness of the intervention and should be tested in a larger and adequately powered trial. The complex nature of tobacco smoking, and considering its historical and social context in Aboriginal communities, suggests that wider and more intensive interventions are needed.

碩士
亞洲大學
健康產業管理學系健康管理組
102
Background For a long time, drinking characterizes the indispensable common feature of social activities. However, excessive drinking will raise the risk of acquiring chronic diseases and further burden to the society. For example, drinking during pregnancy will cause fetal alcohol syndrome or premature birth complications, which is harmful to the health and development of the newborns. Taiwan's aboriginal population, occupying about 2% of the total population, possesses high alcohol consumption prevalence. For example, the prevalence rate of drinking in aboriginal married women is 67.7%. Several results have showed that the intervention of health education has impact on drinking behavior. Therefore, this study intends to exam the influencing factors on various types of health promotion activities those aboriginal women with drinking habits have participated. Objective There are two objectives in this research, namely: (1) to understand the distribution of health promotion activities participated by aboriginal women in different degrees of drinking moderation; (2) to analyze the influencing factors of various types of health promotion activities those aboriginal women in child-bearing ages have participated. Method This study adopted a secondary data analysis. The source of data came from the research project of "The Study on The Health Behavior and Reproductive Risk Factors among Aboriginal Woman of Child-Bearing Ages in Year 2012", authorized by Health Promotion Administration. After screening the data bank, we retrieved 30 aboriginal women of childbearing ages and drinking habits, living in 9 villages of Ren-Ai Township of Nantou County as our research subjects. SPSS software for Windows12.0 version was employed as a statistical tool to execute the descriptive analyses, bivariate analysis and linear regression analysis. Results The results showed, "occupation", "invitation of friends and neighbors", and "medical professionals’ recommendation", will affect aboriginal women of childbearing age to participate more health promotion activities. For example, “invitation of friends and neighbors” (ß=0.574), and "medical professionals’ recommendation" (ß=0.574) have positive effects on aboriginal women’ behavior to participate in the engagement of drinking moderation during pregnancy declaration. Similarly, "occupation" (ß = 0.614), and "medical professionals’ recommendation" (ß=1.093) have positive effects on aboriginal women’ willingness to participate in the handicrafts consensus camp. In addition, household wives (ß = 0.677) tended to participate frequently in the “alcohol abstinence health promotion program” and “quitting betel-nut chewing health promotion program”. Conclusion& Suggestion Invitation of friends and neighbors, and medical professionals’ recommendation indeed can influence the intention of aboriginal women to participate in various health promotion activities. Hopefully, continuous financial subsidy can ensure the versatility of health promotion activities. In addition, the study’s results also showed the design of health promotion should be more feasible on time schedule, with the help of friends and neighbors’ invitation, as well as medical professionals’ recommendation, the aboriginal women would be encouraged to participate more health promotion activities.

The goal of this study is to critically examine health information sources in order to determine whether Aboriginal women are represented in these resources, and if so, how they are being presented. This research is intended to illuminate the practices around the construction of information, and to demonstrate that the manners in which information is conveyed can be problematic. To accomplish these goals, critical discourse analysis was utilized to explore both consumer health publications available to pregnant women in Edmonton, Alberta, as well as academic publications available to students and healthcare providers through the University of Alberta Libraries. Through this critical analysis of these resources, it is clear that information is being constructed in a manner that supports neocolonial practices and reinforces negative stereotypes of Aboriginal women. The analysis of these sources also demonstrates ways in which information can be constructed more appropriately, to avoid racializing tendencies.

Research Doctorate - Doctor of Philosophy (PhD)
This thesis by publication is a body of work containing an introduction, six papers and a closing chapter with conclusions and recommendations for future practice, policy and research. All papers explore the area of concern being smoking during pregnancy among Aboriginal and Torres Strait Islander women, with a focus on how expectant mothers can be empowered to quit smoking. At the time of submission of this thesis, three of the six papers have been published or accepted for publication in peer-reviewed journals and the other three are under review.

碩士
亞洲大學
健康產業管理學系健康管理組
102
Background In recent years, health hazard caused by excessive drinking has become an important global issue. According to the World Health Organization (WHO) published in February 2011, alcoholism not only endangers the drinker's physical and mental health, but also has a negative impact on people around. The 1998 Statistics of Ministry of Health and Welfare show that the proportion of indigenous people who experience drinking is much higher than that in the general Han Chinese (75.2% VS 57.4%). In addition, a study has pointed out the frequency reduction of alcohol drinking among aboriginal women in child-bearing ages is significantly correlated with the total number of all types of health promotion activities they have participated. Therefore, we want to study further effects of drinking frequency change on various health promotion activities in details. Objective There are three objectives in this research, namely: (1)Comparing the distribution of health promotion activities among the participating aboriginal women in child-bearing ages.(2) Observing the frequency changes of drinking among aboriginal women in child-bearing ages before and after their participation in health promotion activities.(3) Analyzing the impacts of various health promotion activities participation on the frequency changes of drinking in aboriginal women of child-bearing ages. Hopefully, the results could be a reference for better design of health promotion activities combination to enhance the maternal and child health. Methods This study adopted a secondary data analysis. The source of data came from the research project of "The Study on The Health Behavior and Reproductive Risk Factors among Aboriginal Woman in Child-Bearing Ages in Year 2012", authorized by Health Promotion Administration. The research subjects were 64 aboriginal women of childbearing ages and drinking habits, living in 9 villages of Ren-Ai Township, Nantou County. The software of SPSS 12.0 version was employed as a statistical tool to proceed both descriptive and inferential analyses.. Results The results showed that there is no statistical relationship between social demographic characteristics and the reduction of drinking frequency among aboriginal women of child-bearing ages. In addition, the influencing factors are "Participating in the engagement of drinking moderation during pregnancy” (OR = 2.49), "Participating in the quitting betel-nut chewing health promotion program" (OR = 2.71), “Participating in the balanced diet health promotion program" (OR = 2.71). Conclusion & Suggestion More participating in the engagement of drinking moderation during pregnancy, quitting betel-nut chewing health promotion program, and the balanced diet health promotion program can help reducing the drinking frequency in aboriginal women of childbearing ages. Therefore, we recommend that the Government can combine those self-assessed and evidence-based health promotion activities to attract more aboriginal women to participate in drinking abstinence program. Besides, the sufficient financial subsidy can ensure the reduction of drinking frequency, while those aboriginal women are more exposed to the health promotion atmosphere.

ABSTRACT Background. A wealth of data highlights the health disparities and barriers to health care experienced by Aboriginal women and children when compared to non-Aboriginal women and children. The first thousand days time period, from conception to the age of two, is an opportunity for health professionals to positively impact the health of Aboriginal children with effects lasting into adulthood. Cultural safety has been reported to improve access to health care for Aboriginal Canadians, but little is known about the significance of cultural safety from the perspective of Aboriginal women during the first thousand days. Methodology. An interpretive descriptive design and a postcolonial perspective guided this study. In-depth interviews were conducted with six Aboriginal women at a community health centre located in the inner-city of Regina, Saskatchewan, between June and July of 2015. Data was analyzed using principles of interpretive description to determine themes. Findings. Culturally safe and unsafe care was experienced during the first thousand days. Three themes common to participants included: the importance of being able to trust that they are safe when accessing health care, the overwhelming impact of poverty on their ability to achieve or maintain good health, and finally, the experience of worry related to the first thousand days including the worry about being worthy of respectful, culturally safe treatment by all employed in health environments. Discussion. The perception of culturally safe care was significant in affecting access to health care for this group of participants. Findings of this study suggest that more attention needs to be paid to the development of trust in health care encounters, and future research could explore the concept of trust for Aboriginal peoples. Emphasis on awareness of the social determinants of health, including colonialism and racism, should be included in educational programming for health professionals locally.

Over the past decade, the "problem" of Fetal Alcohol Syndrome and Fetal Alcohol Effects among Aboriginal peoples has received increasing attention from the Canadian nation-state. However, few feminist, anti-racist, anti-ableist, and anti-colonial scholars have offered a critique of FAS/E "prevention" policies aimed at Aboriginal women. In this dissertation, I present my analysis of the "official knowledge" and "public pedagogies" articulated in one such policy, The First Nations and Inuit Fetal Alcohol Syndrome/ Fetal Alcohol Effects Initiative (herein "the Initiative"). This analysis unravels the complex and contradictory tensions in contemporary state policy formation. My findings show how the Initiative paradoxically supports the development of inclusive, grassroots approaches to FAS/E prevention in Aboriginal communities while at the same time eclipsing the voices and concerns of Aboriginal women. Though neglected in the official policy texts and talk of the Initiative, young Aboriginal mothers' agency and insights are central in the dialectic of ideology, discourse, and lived experience that this study documents. To facilitate this shift, I engage a productive methodological synthesis of textual analysis, institutional ethnography, and participatory research, by grounding my analysis of the texts in indepth group interviews with six Aboriginal mothers whose lives include substance use and FAS/E. This study offers significant implications for the development of future policy, research, and "culturally appropriate" pedagogy for and about FAS/E "prevention". My findings do not support the outright rejection of medical models of disability, as has been favoured by many critical theorists and activists on the grounds that such models are universally oppressive and disenfranchising. Rather, the women's insights into their own lived experiences emphasize the simultaneously enabling and disabling consequences of medicalization. Accordingly, my findings underscore the urgent need to reconsider the roles of "race", gender, class, nation and dis/ability in contemporary theories and practices of substantive citizenship and nation-building in and outside of education.
Education, Faculty of
Educational Studies (EDST), Department of
Graduate

Thesis (Ph.D.)--York University, 2006. Graduate Programme in History.
Typescript. Includes bibliographical references (leaves 261-280). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://proquest.umi.com/pqdweb?index=2&did=1251850601&SrchMode=1&sid=4&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1195659877&clientId=5220

碩士
亞洲大學
健康產業管理學系健康管理組
102
Background According to the World Health Organization, Drinking is a global problem in 2011. It will result in nearly 250 million people each year deaths, and there are 60 kinds of diseases and significantly associated with alcohol misuse. A result: Over 18 years the proportion of Aboriginal Drinking is much higher than Han people. Objective There are two objectives in this research, namely: (1) Aboriginal women of childbearing age drinking conscious understanding of health education in the five largest health promotion approach in order to help analyze. 2. To investigate Ottawa Charter for Health Promotion changes in alcohol-related knowledge, attitude and behavior influence Method This study adopted a secondary data analysis. The source of data came from the research project of "The Study on The Health Behavior and Reproductive Risk Factors among Aboriginal Woman of Child-Bearing Ages in Year 2012", authorized by Health Promotion Administration. After screening the data bank, we retrieved 30aboriginal women of childbearing ages and drinking habits, living in 9 villages of Ren-Ai Township of Nantou County our research subjects. SPSS software for Windows12.0version was employed as a statistical tool to execute the descriptive analyses, bivariate analysis and linear regression analysis. Results The results show that in the five health promotion approach, "Alcoholics health education advocacy programs" (70.3%) are women of childbearing age conscious abstinence Aboriginal health education to help the greatest way to "cherish your pregnancy period of their baby - you do not drink health education advice line "(29.7%) is less a way to help them consciously. However, those who feel that participate in the "treasure you have a baby - you do not drink alcohol during pregnancy Friends Club" on abstinence has helped Aboriginal women of childbearing age, they not only answer the questions in the knowledge temperance number but showing deterioration (ß = -0.684) of situation, but also in terms of alcohol consumption on average drink cup 1.379; Similarly, think participate in the "arts and crafts (such as tapestries, etc.) consensus camp on abstinence has helped Aboriginal women of childbearing age, they drink an average of 1.886 in terms of alcohol consumption cup. Conclusion& Suggestion Ottawa charter viewpoint to discuss the results of this study, Aboriginal conscious women of childbearing age, "the development of personal skills" (i.e., alcohol health education advocacy courses) for them to help the largest health education on alcohol, it is recommended that the unit is still involved in health education continued development of personal skills to teach to the original starting point, but be careful with other health promotion approach for Aboriginal women of childbearing age drinking knowledge, attitudes, and behavior change on the counter-effect to enabling them to quit (section) wine on the degree of improvement can be maintained.

The concept of ‘artistic terra nullius’ refers to the violent erasure of First Nations peoples in colony Australia and highlights their absence – particularly Aboriginal Women – in the white-dominated arts world. This doctoral research by creative project and exegesis sets out to document and respond to the work of Aboriginal women in art and community. I have used practice-led inquiry as the main methodology, informed by my own roles as artist, writer, curator, community researcher and as a Wemba-Wemba & Gunditjmara, matriarchal and sovereign woman. Practising community ways of 'being, knowing and doing' to witness, participate and respond to Aboriginal women's art making and activism, I developed a new body of visual works and a series of essays, together with an exegesis relating to the project as a whole. The exhibition in December 2019 at Footscray Community Arts Centre held two bodies of work in two spaces. The ontological (or Being) space was a healing space of unconditional love, one of memory, timelessness, and respite. It has been created as 'daily acts of repair' in collaboration with other Aboriginal women and family members in a new process of bush dyeing fabrics, clothing and rags to become 'healing cloths”, dyed with gathered gum leaves, bush flowers, plants and Wemba-Wemba family bush medicine gifted to me from my Aunties. As a three-dimensional space, it makes visible trauma trails and stains and visualises what respite and healing could look and feel like. Under the 1961 flickering Super-8 image of my great-grandmother, this space also recreates ‘home’, particularly resonating with Aboriginal women’s curation of ‘home’ even in Mission housing. The second space, an epistemological (or Knowing) space, was an active studio of photographic based works drawn from matriarchal family stories, both past, present and future, and archival research. It included scholarly and other literature on Blak art and representation, in a recreation of my home studio and office. These bodies of work were made over a four-year project, drawing on concepts of de-colonising, Aboriginal feminist standpoint theory (Moreton- Robinson) and sovereignty. In emphasising making art as both research and artistic outcomes, I demonstrate art as a sovereign act, based in cultural practice and sovereign values. Both the exhibition spaces and the exegesis weave across past, present and future, across research in family, community and the Aboriginal women’s arts-work, across multiple creative media and stories – in the process here called ‘Ghost Weaving’. Responding to various modes of oppression, patriarchy and racism, Blak women’s art is not only a form of resistance to colonising, to violence, to academia and the white art world. It is also an ethical foregrounding of other forms of knowing and being. The exegesis is in two main parts: the written, thesis-element and a series of appendices which include a pictorial record of the exhibition, links and lists of related works, including relevant essays.