The Her Tribe and His Tribe Aboriginal-Designed Empowerment Programs.

This study documents evaluation of the Her Tribe and His Tribe Aboriginal-designed empowerment pilot programs. The programs were designed to support Victorian Aboriginal people to strengthen mental health, social and emotional wellbeing, community connection, and to reduce psychological distress. A second aim was to explore participants' experiences of the programs, including the feasibility and acceptability of the evaluation component. Her Tribe ran for 16 weeks and His Tribe for 12 weeks. In total, 43 women and 26 men completed assessments at pre- and post-program completion, and 17 and 10, respectively, participated in yarning circles at the 6-month follow up. For both programs, there were significant increases in participants' access to personal strengths and resources, relationship-community-cultural strengths and resources, and decreases in psychological distress. These changes were associated with small to moderate effects that were maintained at the 6-month follow up. There was a significant increase in aerobic fitness for female but not male participants, and no significant changes in weight for either group. Participants described a range of benefits from the programs, including positive elements and areas for improvement. They also viewed the evaluation as feasible and acceptable, and the findings of value. The outcomes from both pilot programs provide evidence that Aboriginal-designed programs, with a focus on physical and cultural activities, can help to strengthen mental health and wellbeing, community connection, and reduce psychological distress in Victorian Aboriginal communities.

Collaborative Social-Epidemiology: A Co-analysis of the Cultural and Structural Determinants of Health for Aboriginal Youth in Victorian Schools.

Social-epidemiology that excludes Aboriginal voices often fails to capture the full and complex social worlds of Aboriginal people. Using data from an existing co-designed Victorian government Adolescent Health and Wellbeing Survey (2008/9), we worked with Aboriginal organizations to identify data priorities, select measures, interpret data, and contextualize findings. Using this participatory co-analysis approach, we selected "cultural" and "structural" determinants identified by Aboriginal organizations as important and modelled these using principal component analysis. Resulting components were then modelled using logistic regression to investigate associations with "likely being well" (Kessler-10 score < 20) for 88 Aboriginal adolescents aged 11-17 years. Principal component analysis grouped 11 structural variables into four components and 11 cultural variables into three components. Of these, "grew up in Aboriginal family/community and connected" associated with significantly higher odds of "likely being well" (OR = 2.26 (1.01-5.06), p = 0.046). Conversely, "institutionally imposed family displacement" had significantly lower odds (OR = 0.49 (0.24-0.97), p = 0.040) and "negative police contact and poverty" non-significantly lower odds (OR = 0.53 (0.26-1.06), p = 0.073) for "likely being well". Using a co-analysis participatory approach, the voices of Aboriginal researchers and Aboriginal organizations were able to construct a social world that aligned with their ways of knowing, doing, and being. Findings highlighted institutionally imposed family displacement, policing, and poverty as social sites for health intervention and emphasized the importance of strong Aboriginal families for adolescents.

Developing a framework identifying the outcomes, principles and enablers of 'gathering places': Perspectives from Aboriginal people in Victoria, Australia.

Aboriginal 'gathering places' have been described as cultural hubs, healing centres, and social meeting places. This article explores a gap in the literature on the health and wellbeing outcomes of gathering places from the perspectives of Aboriginal people who attend them. The aim of this study was to develop a framework to articulate the enablers, principles, and outcomes of 'successful' Aboriginal gathering places. In this study, sixty-nine (n = 69) community members participated in qualitative interviews or focus group discussions across thirteen gathering place sites in Victoria (Australia). The research found that gathering places address social health disparities through the provision of a broad range of health and wellbeing programs that benefit Aboriginal community members accessing them. Gathering places were described by participants as providing connections to place, Aboriginal culture, and healing and mainstream health services that enhanced wellbeing. These findings contribute to a better understanding of how Aboriginal gathering places function and offer strategies for creating culturally safe and welcoming settings for Aboriginal peoples, with potential for consideration in international contexts. This research informed a best-practice framework and outlines different models for developing community empowering and culturally affirming gathering places for improving Aboriginal people's access to culturally appropriate health and support services, while simultaneously reducing health and social inequalities. Key elements of this framework that contribute to a successful gathering place include the people, place (location/facilities), programs and community themselves, whilst the principles that enable these places include elements like self-determination, respect of culture, sustainability and strong governance.

"Here we are part of a living culture": Understanding the cultural determinants of health in Aboriginal gathering places in Victoria, Australia.

This article provides an exploration of the cultural determinants of health, based on a research evaluation investigating a number of Aboriginal gathering places in Victoria (Australia). Gathering places are recognised as settings in which people practice and learn about local Aboriginal culture, history and place. Academic literature on gathering places is sparse. Thirteen gathering places were evaluated in this research. Each site is unique and has a specific story that connects it to the history and geography of the place in which it is located. Sixty-nine gathering place members participated in qualitative semi-structured interviews or focus groups. Using thematic analysis, the findings were divided into four key themes associated with cultural determinants of health (social networks; inclusiveness; empowerment; connections). These elements create a safe place to learn about culture and Country, and support an environment for strengthening identity, improving health and building resilience. The findings from this study highlight the benefits of using gathering places to explore the cultural determinants of health.

Health and wellbeing outcomes of programs for Indigenous Australians that include strategies to enable the expression of cultural identities: a systematic review.

Indigenous people have long maintained that strong cultural identities are critical to health and wellbeing. The purpose of this systematic review is to examine whether interventions that entail strategies to enable expression of cultural identities for Australian Indigenous peoples are associated with measurable improvements in health and wellbeing. Peer-reviewed articles that reported quantitatively expressed health and wellbeing outcomes involving Indigenous Australian participants only were included. The cultural intervention component was defined and assessed by Indigenous researchers on the team. A narrative analysis was conducted. The protocol was registered on PROSPERO (CRD42015027387). Thirteen articles describing eleven studies were identified, including one randomised control trial (RCT), one cluster RCT and two studies with non-randomised controls. Other studies reported on case series or cross-sectional studies. All except two studies described multiple intervention strategies. Eight studies showed significant improvement in at least one psychosocial, behavioural or clinical measure, with two showing a positive direction of effect and one showing no improvement. Publication bias may discourage researchers to report negative findings of these interventions. Although studies vary in quality, this review provides evidence that interventions that include opportunities for expression of cultural identities can have beneficial effects for Australian Indigenous peoples.

The community network: an Aboriginal community football club bringing people together.

There are few empirical studies about the role of Aboriginal sporting organisations in promoting wellbeing. The aim of the present study was to understand the impact of an Aboriginal community sporting team and its environment on the social, emotional and physical wellbeing of young Aboriginal men, and to identify barriers and motivators for participation. A literature review of the impact of sport on the health and wellbeing of Aboriginal participants was conducted. This informed a qualitative study design with a grounded theory approach. Four semistructured interviews and three focus groups were completed with nine current players and five past players of the Fitzroy Stars Football Club to collect data about the social, emotional and physical wellbeing impact of an Aboriginal football team on its Aboriginal players. Results of the interviews were consistent with the literature, with common concepts emerging around community connection, cultural values and identity, health, values, racism and discrimination. However, the interviews provided further detail around the significance of cultural values and community connection for Aboriginal people. The complex nature of social connections and the strength of Aboriginal community networks in sports settings were also evident. Social reasons were just as important as individual health reasons for participation. Social and community connection is an important mechanism for maintaining and strengthening cultural values and identity. Barriers and motivators for participation in Aboriginal sports teams can be complex and interrelated. Aboriginal sports teams have the potential to have a profound impact on the health of Aboriginal people, especially its players, by fostering a safe and culturally strengthening environment and encompassing a significant positive social hub for the Aboriginal community.

Suicide ideation and attempt in a community cohort of urban Aboriginal youth: a cross-sectional study.

BACKGROUND: There has been increasing attention over the last decade on the issue of indigenous youth suicide. A number of studies have documented the high prevalence of suicide behavior and mortality in Australia and internationally. However, no studies have focused on documenting the correlates of suicide behavior for indigenous youth in Australia. AIMS: To examine the prevalence of suicide ideation and attempt and the associated factors for a community1 cohort of Koori2 (Aboriginal) youth. METHOD: Data were obtained from the Victorian Aboriginal Health Service (VAHS) Young People's Project (YPP), a community initiated cross-sectional data set. In 1997/1998, self-reported data were collected for 172 Koori youth aged 12-26 years living in Melbourne, Australia. The data were analyzed to assess the prevalence of current suicide ideation and lifetime suicide attempt. Principal components analysis (PCA) was used to identify closely associated social, emotional, behavioral, and cultural variables at baseline and Cox regression modeling was then used to identify associations between PCA components and suicide ideation and attempt. RESULTS: Ideation and attempt were reported at 23.3% and 24.4%, respectively. PCA yielded five components: (1) emotional distress, (2) social distress A, (3) social distress B, (4) cultural connection, (5) behavioral. All were positively and independently associated with suicide ideation and attempt, while cultural connection showed a negative association. CONCLUSIONS: Suicide ideation and attempt were common in this cross-section of indigenous youth with an unfavorable profile for the emotional, social, cultural, and behavioral factors.