Giri-nya-la-nha (talk together) to explore acceptability of targeted smoking cessation resources with Australian Aboriginal women.

OBJECTIVES: To engage with health providers and Aboriginal women to understand what educational resources they want and need to support quit smoking attempts during pregnancy in order to develop a comprehensive evidence-based intervention. STUDY DESIGN: Resources were developed in partnership with Aboriginal people, communities and academics with the aim to be inclusive of diverse communities. We then recruited Aboriginal women of various ages for yarning circles (focus groups) held in three Australian states to explore the acceptability of the resources and seeking further guidance as to the needs of Aboriginal women to support smoking cessation during pregnancy. METHODS: Yarning circles were recorded and transcribed, and data were analysed independently by two researchers. Responses were coded using predetermined themes and further general inductive analysis for emergent themes. RESULTS: Twenty-four Aboriginal women reflected on the resources they included: one pregnant woman, 15 mothers and eight elders. Predetermined themes of attraction, comprehension, cultural acceptability, graphics and layout, persuasion and self-efficacy were explored. Women suggested the following: resources need to be visually attractive and interactive to enhance self-efficacy; additional scientific content on health consequences of smoking and combining with non-pharmacological approaches to quitting. CONCLUSION: Indigenous peoples prefer culturally targeted messages. However, developing effective Aboriginal health promotion requires more than a 'culturally appropriate' adaptation of mainstream resources. Consideration needs to be given to the diversity of Aboriginal communities when developing effective, evidence-based interventions. Aboriginal women are calling for innovative and interactive resources that enhance self-efficacy; the use of videos to explain medical and informational brochure content is well received. Requests for non-pharmacological cessation options were reported in New South Wales and Queensland and should be further explored.

Improving cervical screening in a remote aboriginal community.

Improved cervical screening has been identified as a priority in reducing the incidence of cervical cancer among Aboriginal women. This paper discusses the cervical screening recommendations of a women's health project developed by Nganampa Health Council (NHC), the Aboriginal-controlled medical service meeting the health needs of the people of the Anangu Pitjantjatjara (AP) Lands. A community participation public health model was used in program development. A process including community and staff consultation, literature review and prioritisation informed the program development, ensuring strategies thereby derived were culturally acceptable as well as practical and scientifically valid. The epidemiology of cervical cancer and screening in this community is discussed. Strategies aimed at maximising patient participation, improving patient satisfaction, running an effective call and recall system, improving quality of cervical smears, improving management of women with abnormal smears and evaluating the program are suggested. The involvement of the community in a scientifically sound, public health approach may increase the likelihood that the strategies suggested will be effective in this community. Both the model of program development and the cervical screening strategies derived are likely to be of relevance for other Aboriginal communities.

Cervical cytology in central Australian Aboriginal women.

Cervical smears were taken from 113 Aboriginal women who attended an Aboriginal community controlled health service in Alice Springs for gynaecological, obstetric or other unrelated conditions over a 6 month period. Nine women (8%) had cervical atypia and two (1.8%) had cervical intraepithelial neoplasia. These rates are similar to those observed among other population groups in larger Australian and overseas studies, as was the high prevalence of abnormal smears in women under 25 years of age (11% of this age group). Urban dwellers had a higher prevalence of abnormal smears (15%) compared with town camp and rural women (2%). This pilot study emphasises the importance of routine screening for central Australian Aboriginal women and identifies possible risk groups for further research.