Journeying towards decolonising Aboriginal and Torres Strait Islander oral health re-search.

OBJECTIVES: Arguably, the deficit narrative of oral health inequities, perpetuated by colonial re-search agendas, media and sociopolitical discourse, contributes to oral disease burden and fatalism among Aboriginal and Torres Strait Islander Peoples. There remains a need to evolve the way oral health is understood, in a manner that reflects the lived experiences of Aboriginal and Torres Strait Islander Peoples. METHODS: This paper proposes decolonising methodologies as a strategy to ensure oral health re-search creates more equitable oral health outcomes and realities for Aboriginal and Torres Strait Islander Communities. Anchored by a critical reflection of the failure of dominant oral health inequity re-search practices to address Indigenous oral health, both in Australia and internationally, we propose five explicit pathways for decolonising Aboriginal and Torres Strait Islander oral health re-search. RESULTS: We argue the need for (1) positionality statements in all re-search endeavours, (2) studies that honour reciprocal relationships through the development of proposals that ask questions and follow models based on Traditional Knowledges, (3) the development of culturally secure and strengths-based data capturing tools, (4) frameworks that address the intersection of multiple axes of oppression in creating inequitable conditions and (5) decolonising knowledge translation techniques. CONCLUSION: Importantly, we recognize that re-search will never be entirely 'decolonised' due to the colonial foundations upheld by academic institutions and society more broadly; however, as oral health re-searchers, we ascertain that there is an ethical compulsion to drive decolonising re-search pursuits that produce equitable oral health outcomes for Aboriginal and Torres Strait Islander Communities.

Cohort profile: South Australian Aboriginal Birth Cohort (SAABC)-a prospective longitudinal birth cohort.

PURPOSE: The South Australian Aboriginal Birth Cohort (SAABC) is a prospective, longitudinal birth cohort established to: (1) estimate Aboriginal child dental disease compared with population estimates; (2) determine the efficacy of an early childhood caries intervention in early versus late infancy; (3) examine if efficacy was sustained over time and; (4) document factors influencing social, behavioural, cognitive, anthropometric, dietary and educational attainment over time. PARTICIPANTS: The original SAABC comprised 449 women pregnant with an Aboriginal child recruited February 2011 to May 2012. At child age 2 years, 324 (74%) participants were retained, at age 3 years, 324 (74%) participants were retained and at age 5 years, 299 (69%) participants were retained. Fieldwork for follow-up at age 7 years is underway, with funding available for follow-up at age 9 years. FINDINGS TO DATE: At baseline, 53% of mothers were aged 14-24 years and 72% had high school or less educational attainment. At age 3 years, dental disease experience was higher among children exposed to the intervention later rather than earlier in infancy. The effect was sustained at age 5 years, but rates were still higher than general child population estimates. Experiences of racism were high among mothers, with impacts on both tooth brushing and toothache. Compared with population estimates, levels of self-efficacy and self-rated oral health of mothers at baseline were low. FUTURE PLANS: Our data have contributed to a better understanding of the environmental, behavioural, dietary, biological and psychosocial factors contributing to Aboriginal child oral and general health, and social and emotional well-being. This is beneficial in charting the trajectory of cohort participants' health and well-being overtime, particularly in identifying antecedents of chronic diseases which are highly prevalent among Aboriginal Australians. Funding for continued follow-up of the cohort will be sought. TRIAL REGISTRATION NUMBER: ACTRN12611000111976; Post-results.

Ethnic-racial identity affirmation: Validation in Aboriginal Australian children.

INTRODUCTION: Positive attitudes towards ethnic-racial identity (ERI) is a key factor in Aboriginal Australian children's development. The present study aims to offer evidence of construct and criterion validity, reliability, and measurement invariance of a brief measure of Aboriginal children's ERI affirmation. METHODS: Data was from 424 children aged 10-12 years (mean 10.5 years; SD 0.56) participating in the 8th wave of the Longitudinal Study of Indigenous Children (LSIC). Information on ERI was obtained from 4 child-reported items. Sociodemographic characteristics and child social and emotional outcomes were caregiver-reported. A factorial structure was tested by Confirmatory Factor Analysis. The estimation method was weighted least squares with mean and variance adjusted test statistic (WLSMV). For reliability verification, the ordinal α and Ω hierarchical α were assessed. For construct validity, a generalized linear model with log-Poisson link estimated the association between ERI and children's social and emotional outcomes. We hypothesized that children with positive ERI would have lower behavioural and emotional difficulties. RESULTS: We found evidence of excellent fit for a unidimensional model of ERI affirmation after adjusting for correlated uniqueness between items 1 and 3 (χ2(2) = 0.06, p = 0.80; RMSEA = 0.000 [90% CI 0.000-0.080], p = 0.088; CFI = 1.000). Internal consistency reliability was considered adequate (ordinal α = 0.83; Ω hierarchical α = 0.72). The unidimensional model was shown to be invariant among boys and girls (Δχ2 (4) = 6.20, p = 0.18; ΔCFI = 0.000). Higher ERI was associated with lower risk of problematic scores (>17) on the SDQ (Risk Ratioa = 0.91, 95% CI 0.64, 1.29). DISCUSSION: The four LSIC items perform as a brief measure of Aboriginal children ERI affirmation among boys and girls. Results contribute much needed evidence for LSIC's ongoing success and to future research on Aboriginal children's development and wellbeing.