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1.
Health Qual Life Outcomes ; 19(1): 81, 2021 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-33691744

RESUMO

INTRODUCTION: In Australia, health-related quality of life (HRQoL) instruments have been adopted in national population surveys to inform policy decisions that affect the health of Aboriginal and Torres Strait Islanders. However, Western-developed HRQoL instruments should not be assumed to capture Indigenous conceptualization of health and well-being. In our study, following recommendations for cultural adaptation, an Indigenous Reference Group indicated the EQ-5D-5L as a potentially valid instrument to measure aspects of HRQoL and endorsed further psychometric evaluation. Thus, this study aimed to investigate the construct validity and reliability of the EQ-5D-5L in an Aboriginal Australian population. METHODS: The EQ-5D-5L was applied in a sample of 1012 Aboriginal adults. Dimensionality was evaluated using Exploratory Graph Analysis. The Partial Credit Model was employed to evaluate item performance and adequacy of response categories. Area under the receiver operating characteristic curve (AUROC) was used to investigate discriminant validity regarding chronic pain, general health and experiences of discrimination. RESULTS: The EQ-5D-5L comprised two dimensions, Physiological and Psychological, and reliability was adequate. Performance at an item level was excellent and the EQ-5D-5L individual items displayed good discriminant validity. CONCLUSIONS: The EQ-5D-5L is a suitable instrument to measure five specific aspects (Mobility, Self-Care, Usual activities, Pain/Discomfort, Anxiety/Depression) of Aboriginal and Torres Strait Islander HRQoL. A future research agenda comprises the investigation of other domains of Aboriginal and Torres Strait Islander HRQoL and potential expansions to the instrument.


Assuntos
Grupo com Ancestrais Oceânicos/psicologia , Qualidade de Vida , Inquéritos e Questionários/normas , Adulto , Austrália , Dor Crônica/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Curva ROC , Racismo/psicologia , Reprodutibilidade dos Testes
2.
Aust N Z J Public Health ; 45(2): 150-157, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33683744

RESUMO

OBJECTIVE: To investigate perspectives of primary health care providers (HCPs) on providing cervical screening for Aboriginal and Torres Strait Islander women, who experience a higher burden of cervical cancer than other Australian women. METHODS: Semi-structured interviews with 13 HCPs from four Australian Indigenous primary health care centres (PHCCs). Transcripts were thematically analysed. RESULTS: HCPs discussed the need to approach cervical screening with sensitivity to women's emotional and cultural needs and sustaining relationships built on trust and respect. HCPs reported challenges in promoting screening to Aboriginal and Torres Strait Islander women due to cumbersome systems, competing clinical priorities, workforce capacity limitations and specific challenges associated with implementing the renewed National Cervical Screening Program. CONCLUSIONS: In practice, HCPs experience several challenges to delivering cervical screening. Understanding HCPs' perspectives on their approach to cervical screening delivery, and the systems in which this occurs, can help to ensure that they receive adequate support and resources to deliver cervical screening to Aboriginal and Torres Strait Islander women. Implications for public health: It is important that HCPs adopt a multi-faceted, person-centred approach to cervical screening that is responsive to women's needs and that works synchronously with supportive PHCC services and systems and the National Cancer Screening Register.


Assuntos
Competência Cultural , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Programas de Rastreamento , Atenção Primária à Saúde/organização & administração , Neoplasias do Colo do Útero , Adulto , Austrália , Detecção Precoce de Câncer , Feminino , Serviços de Saúde do Indígena , Humanos , Entrevistas como Assunto , Programas de Rastreamento/métodos , Programas de Rastreamento/psicologia , Grupo com Ancestrais Oceânicos/psicologia , Relações Profissional-Paciente , Pesquisa Qualitativa , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle
3.
BMC Cancer ; 21(1): 121, 2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33541294

RESUMO

BACKGROUND: Lung Cancer is the leading cause of cancer deaths in Aotearoa New Zealand. Maori communities in particular have higher incidence and mortality rates from Lung Cancer. Diagnosis of lung cancer at an early stage can allow for curative treatment. This project aimed to document the barriers to early diagnosis and treatment of lung cancer in secondary care for Maori communities. METHODS: This project used a kaupapa Maori approach. Nine community hui (focus groups) and nine primary healthcare provider hui were carried out in five rural localities in the Midland region. Community hui included cancer patients, whanau (families), and other community members. Healthcare provider hui comprised staff members at the local primary healthcare centre, including General Practitioners and nurses. Hui data were thematically analysed. RESULTS: Barriers and enablers to early diagnosis of lung cancer were categorised into two broad themes: Specialist services and treatment, and whanau journey. The barriers and enablers that participants experienced in specialist services and treatment related to access to care, engagement with specialists, communication with specialist services and cultural values and respect, whereas barriers and enablers relating to the whanau journey focused on agency and the impact on whanau. CONCLUSIONS: The study highlighted the need to improve communication within and across healthcare services, the importance of understanding the cultural needs of patients and whanau and a health system strategy that meets these needs. Findings also demonstrated the resilience of Maori and the active efforts of whanau as carers to foster health literacy in future generations.


Assuntos
Detecção Precoce de Câncer/psicologia , Acesso aos Serviços de Saúde , Serviços de Saúde do Indígena/normas , Neoplasias Pulmonares/diagnóstico , Grupo com Ancestrais Oceânicos/psicologia , Atenção Secundária à Saúde/normas , Feminino , Letramento em Saúde , Humanos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/psicologia , Masculino , Nova Zelândia/epidemiologia
4.
Aust N Z J Public Health ; 45(2): 122-128, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33522674

RESUMO

OBJECTIVE: This research seeks to identify climate-sensitive infectious diseases of concern with a present and future likelihood of increased occurrence in the geographically vulnerable Torres Strait Islands, Australia. The objective is to contribute evidence to the need for adequate climate change responses. METHODS: Case data of infectious diseases with proven, potential and speculative climate sensitivity were compiled. RESULTS: Five climate-sensitive diseases in the Torres Strait and Cape York region were identified as of concern: tuberculosis, dengue, Ross River virus, melioidosis and nontuberculous mycobacterial infection. The region constitutes 0.52% of Queensland's population but has a disproportionately high proportion of the state's cases: 20.4% of melioidosis, 2.4% of tuberculosis and 2.1% of dengue. CONCLUSIONS: The Indigenous Torres Strait Islander peoples intend to remain living on their traditional country long-term, yet climate change brings risks of both direct and indirect human health impacts. Implications for public health: Climate-sensitive infections pose a disproportionate burden and ongoing risk to Torres Strait Islander peoples. Addressing the causes of climate change is the responsibility of various agencies in parallel with direct action to minimise or prevent infections. All efforts should privilege Torres Strait Islander peoples' voices to self-determine response actions.


Assuntos
Mudança Climática , Doenças Transmissíveis , Serviços de Saúde do Indígena , Grupo com Ancestrais Oceânicos/psicologia , Austrália , Humanos , Ilhas , Estudos Longitudinais , Inquéritos e Questionários
6.
Aust N Z J Public Health ; 45(1): 59-64, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33559961

RESUMO

OBJECTIVES: To identify and describe chronic disease prevention programs offered by Aboriginal Community Controlled Health Services (ACCHSs) in New South Wales (NSW), Australia. METHODS: ACCHSs were identified through the Aboriginal Health and Medical Research Council of NSW website. Chronic disease programs were identified from the Facebook page and website of each ACCHS. Characteristics, including regions, target population, condition, health behaviour, modality and program frequency were extracted and summarised. RESULTS: We identified 128 chronic disease programs across 32 ACCHSs. Of these, 87 (68%) programs were broad in their scope, 20 (16%) targeted youth, three (2%) targeted Elders, 16 (12%) were for females only and five (4%) were for males only. Interventions included physical activity (77, 60%), diet and nutrition (74, 58%), smoking (70, 55%), and the Aboriginal and Torres Strait Islander Health Check (44, 34%), with 93 programs (73%) of ongoing duration. CONCLUSIONS: Chronic disease prevention programs address chronic conditions by promoting physical activity, diet and nutrition, smoking cessation and health screening. Most target the general Aboriginal community, a few target specific groups based on gender and age, and more than one-quarter are time-limited. Implications for public health: Chronic disease programs that are co-produced with specific groups, based on age and gender, may be needed.


Assuntos
Doença Crônica/prevenção & controle , Comportamentos Relacionados com a Saúde/etnologia , Promoção da Saúde/métodos , Serviços de Saúde do Indígena/estatística & dados numéricos , Estilo de Vida Saudável , Grupo com Ancestrais Oceânicos/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Adolescente , Idoso , Austrália/epidemiologia , Feminino , Humanos , Masculino , New South Wales , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Fumar/epidemiologia , Abandono do Hábito de Fumar/etnologia
7.
Aust N Z J Public Health ; 45(1): 46-52, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33460196

RESUMO

OBJECTIVE: This study reports findings from an uncontrolled evaluation of a course designed to educate participants in how to recognise and respond to mental health problems until professional help is received. METHODS: Utilising a mixed methods design, participants in 21 different courses, delivered across two Australian states, were invited to complete pre-, post-, and follow-up surveys and provide qualitative feedback on their training experiences. RESULTS: Participants reported feeling more confident in their capacity to respond appropriately to a person presenting with a mental health need and believed they would be more likely to provide assistance. Satisfaction was attributed to the skills and sensitivities of instructors who had lived experience of mental health concerns in Aboriginal and Torres Strait Islander communities. CONCLUSION: This course holds promise in improving mental health literacy in relation to Aboriginal and Torres Strait Islander mental health. Implications for public health: Few courses are available that address issues relating to the social and emotional wellbeing of Aboriginal and Torres Strait Islander People. This study illustrates how community engagement with primary health and specialist mental health services might be strengthened.


Assuntos
Competência Cultural , Primeiros Socorros/métodos , Conhecimentos, Atitudes e Prática em Saúde , Serviços de Saúde do Indígena , Saúde Mental/estatística & dados numéricos , Grupo com Ancestrais Oceânicos/psicologia , Avaliação de Programas e Projetos de Saúde/métodos , Adulto , Austrália , Avaliação Educacional , Feminino , Humanos , Entrevistas como Assunto , Masculino , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Satisfação Pessoal , Pesquisa Qualitativa , Inquéritos e Questionários
10.
Aust N Z J Public Health ; 45(1): 39-45, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33347687

RESUMO

OBJECTIVE: To identify factors that may systematically reduce opportunities for Aboriginal and Torres Strait Islander Australians to participate in cancer clinical trials. METHODS: Analysis of online documents from the Australia and New Zealand Clinical Trials Registry for cancer treatment trials (Phase 3, 4 or Not Applicable) with at least one Australian site, registered in 2014-2018. RESULTS: Among 365 eligible trials, most (89%) had sites only in major cities/inner regional areas, but 39% of Aboriginal and Torres Strait Islander Australians live outside these areas. Seven cancer types accounted for 58% of cancers among Aboriginal and Torres Strait Islander people, but only 46% of trials addressed these cancers. Most trials specified exclusions relating to comorbidities/health status. A substantial minority of trials (38%) explicitly referred to investigator opinion/judgment as a relevant determinant of patient eligibility. CONCLUSION: Aboriginal and Torres Strait Islander patients appear to have a reduced opportunity to participate in trials because of where they live, their type of cancer and their general health status, as well as for less transparent reasons relating to investigator judgment. Implications for public health: Greater transparency and greater scrutiny of barriers to trial participation for Aboriginal and Torres Strait Islander Australians are needed to ensure equitable access.


Assuntos
Antineoplásicos/uso terapêutico , Ensaios Clínicos como Assunto , Equidade em Saúde , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Nível de Saúde , Neoplasias/tratamento farmacológico , Adulto , Austrália , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/etnologia , Neoplasias/psicologia , Nova Zelândia , Grupo com Ancestrais Oceânicos/psicologia , Encaminhamento e Consulta
11.
Artigo em Inglês | MEDLINE | ID: mdl-33348723

RESUMO

(1) Background: To explore the function of smoking in Aboriginal women's lives from a trauma-informed, women-centred approach in order to inform the design of a culturally meaningful smoking cessation program for women living in the Pilbara, Western Australia; (2) Methods: Qualitative and Community Based Participatory Action Research (CBPAR) was used to discover what Aboriginal women know about smoking, the specific contextual issues that influence their smoking, and what community supports are available to help them quit smoking. Inductive analysis was used to determine key themes; (3) Results: 25 Aboriginal women (smokers, non-smokers, and ex-smokers) participated in focus groups or individual interviews. Women smoked to deal with stress, trauma and for maintaining social connections. Women who stopped smoking did so on their own when the reason was important enough or when they saw alternative ways of living. Creating safe places to bring women together to yarn about women's business and link with health services was identified as critical to support women to stop smoking. Conclusions: Strategies to address smoking need to bring community, culture and health together in a meaningful way for women and their families; build on existing community strengths; and educate communities about the effects of smoking, and health professionals about how to support women to stop smoking.


Assuntos
Assistência à Saúde Culturalmente Competente , Comportamentos Relacionados com a Saúde/etnologia , Saúde Materna , Grupo com Ancestrais Oceânicos/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar/etnologia , Adulto , Pesquisa Participativa Baseada na Comunidade , Feminino , Grupos Focais , Pesquisa sobre Serviços de Saúde , Serviços de Saúde do Indígena/organização & administração , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Pesquisa Qualitativa , Fumar/psicologia , Abandono do Hábito de Fumar/etnologia , Austrália Ocidental
12.
Int J Equity Health ; 19(1): 222, 2020 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-33317556

RESUMO

BACKGROUND: It is well established that Aboriginal and Torres Strait Islander populations face considerable health inequities, exacerbated by poorer healthcare quality. Patient experience is recognised as a major contributing factor to healthcare quality and outcomes, therefore, enriched knowledge of the patient experiences of Aboriginal and Torres Strait Islander populations is critical to redress health inequities. This review synthesises evidence of the healthcare experiences amongst Aboriginal and Torres Strait Islander patients through a metanarrative synthesis of qualitative literature. METHODS: A systematic search strategy was developed and applied to six electronic databases between January 2000 and July 2019. Titles and abstracts were screened before applying the inclusion criteria to full text articles. A meta-narrative synthesis was undertaken. RESULTS: Fifty-four publications were identified from four research traditions; each with a unique conceptualisation of patient experience. Three themes emerged that demonstrate Aboriginal and Torres Strait Islander patient experiences are informed by 1) beliefs about wellbeing and healthcare provision, 2) their level of trust in the healthcare system, and 3) individual and community health system interactions. The findings highlight a range of aspects of patient experience that were important to participating Aboriginal and Torres Strait Islanders in the included studies but not captured currently in health system surveys. CONCLUSION: This review highlights the influence of beliefs about health and wellbeing on the patient experience amongst Aboriginal and Torres Strait Islander populations in the Australian health system. Patient experiences were informed by past experience and their trust in the health system. The different factors influencing patient experience and the gravity of their influence must be considered in current approaches to capturing patient experience data collection methods. TRIAL REGISTRATION: PROSPERO (ID: CRD42019134765 ).


Assuntos
Atitude Frente a Saúde/etnologia , Assistência à Saúde , Grupo com Ancestrais Oceânicos/psicologia , Austrália , Humanos , Narração
13.
PLoS One ; 15(10): e0239384, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33002023

RESUMO

In recent decades, several studies have emphasized sense of personal control as a prominent aspect of Aboriginal health. However, one limitation is that instruments available to measure personal control were originally developed in western countries and validation for Aboriginal Australians has not been conducted. The aims of the current study were to evaluate whether the Sense of Personal Control Scale (SPCS) can be used to obtain culturally unbiased measurement of personal control across Aboriginal and non-Aboriginal Australians and to assess the psychometric properties of the SPCS for Aboriginal and non-Aboriginal Australian. METHODS: The current study utilized two Australian subsamples retrieved from the Teeth Talk Study (n = 317) and the National Survey of Adult Oral Health 2004-2006 (n = 3,857) in which the SPCS was included. Graphical Loglinear Rasch Models (GLLRM) were used to fulfill the aims of the study. RESULTS: The Perceived Constraints subscale fitted a GLLRM for Aboriginal Australians after the exclusion of three items, while fit to any Rasch model (RM) or GLLRM model could not be found in the non-Aboriginal sample. The Mastery subscale fitted a GLLRM in the non-Aboriginal sample after the exclusion of one item. In the Aboriginal sample, two items of the Mastery subscale fitted the RM, however, two items cannot be considered as a scale. CONCLUSION: In the present study, we showed that the development of new items is crucial before the revised SPCS might constitute a valid and reliable measure of sense of personal control in both Aboriginal and non-Aboriginal Australian populations, and it is possible to assess whether the SPCS can be measured without bias across these two populations.


Assuntos
Inquéritos Epidemiológicos , Grupo com Ancestrais Oceânicos/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/etnologia , Feminino , Serviços de Saúde do Indígena/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Adulto Jovem
14.
Aust N Z J Public Health ; 44(5): 397-403, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32776634

RESUMO

OBJECTIVE: Smoking is a major cause of preventable illness for Aboriginal and Torres Strait Islander people, with most commencing in adolescence. Understanding trends in youth tobacco use can inform prevention policies and programs. METHODS: Logistic regression models examined smoking trends among Aboriginal and Torres Strait Islander and all students aged 12-17 years, in five nationally representative triennial surveys, 2005-2017. Outcomes measured lifetime, past month, past week tobacco use and number of cigarettes smoked daily (smoking intensity). RESULTS: Aboriginal and Torres Strait Islander students' never smoking increased (2005: 49%, 2017: 70%) with corresponding declines in past month and week smoking. Smoking intensity reduced among current smokers (low intensity increased 2005: 67%, 2017: 77%). Trends over time were similar for Aboriginal and Torres Strait Islander students as for all students (8-10% annual increase in never smoking). CONCLUSIONS: Most Aboriginal and Torres Strait Islander students are now never smokers. Comparable declines indicate similar policy impact for Aboriginal and Torres Strait Islander and all students. Implications for Public Health: Comprehensive population-based tobacco control policies can impact all students. Continued investment, including in communities, is needed to maintain and accelerate reductions among Aboriginal and Torres Strait Islander students to achieve equivalent prevalence rates and reduce health inequities.


Assuntos
Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Estudantes/psicologia , Fumar Tabaco/tendências , Adolescente , Austrália/epidemiologia , Criança , Pesquisa Participativa Baseada na Comunidade , Feminino , Humanos , Masculino , Grupo com Ancestrais Oceânicos/psicologia , Estudos Prospectivos , Abandono do Hábito de Fumar/estatística & dados numéricos
15.
Int J Equity Health ; 19(1): 103, 2020 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-32571330

RESUMO

BACKGROUND: Maori men have stark health inequities around non-communicable diseases. This study describes the case of a partnership attempting to develop and implement a culturally centred intervention through a collaborative partnership to potentially address the inequities. In particular, the partnership followed a participatory, co-design approach using the He Pikinga Waiora (HPW) Implementation Framework; the study presents lessons learnt in addressing health inequities following this framework. METHODS: The partnership involved a university research team and a Maori community health provider. They engaged with other stakeholders and several cohorts of Maori men through a co-design process to adapt a 12-week lifestyle intervention. The co-design process was documented through meeting notes and interviews with partners. Two cohorts participated in separate single group pre-intervention/post-intervention designs with multi-method data collection. Key outcome measures included weight loss, self-reported health, physical activity, and nutrition. Post-intervention data collection included qualitative data. RESULTS: The co-design process resulted in a strong and engaged partnership between the university team and the provider. There were significant challenges in implementing the intervention including having two additional partner organisations dropping out of the partnership just after the initial implementation phase. However, a flexible and adaptable partnership resulted in developing two distinct lifestyle interventions run with 32 Maori men (in two different cohorts of 8 and 24). All but one in the first cohort completed the programme. The first cohort had a modest although statistically insignificant improvement in weight loss (d = 1.04) and body mass index (BMI; d = 1.08). The second cohort had a significant reduction in weight loss (d = 1.16) and BMI (d = 1.15). They also had a significant increase in health-related quality of life (d = 1.7) and self-rated health (d = 2.0). CONCLUSION: The HPW Framework appears to be well suited to advance implementation science for Indigenous communities in general and Maori in particular. The framework has promise as a policy and planning tool to evaluate and design interventions for chronic disease prevention in Indigenous communities. Despite this promise, there are structural challenges in developing and implementing interventions to address health inequities. TRIAL REGISTRATION: Retrospectively registered, Australia New Zealand Clinical Trials Registry, ACTRN12619001783112.


Assuntos
Terapia Comportamental/métodos , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/prevenção & controle , Exercício Físico/psicologia , Obesidade/prevenção & controle , Grupo com Ancestrais Oceânicos/educação , Grupo com Ancestrais Oceânicos/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estilo de Vida Saudável , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto/métodos
16.
Aust N Z J Public Health ; 44(4): 279-283, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32583522

RESUMO

OBJECTIVES: Determine major barriers to, and facilitators of, influenza vaccination of Aboriginal adults, in order to improve coverage from the current level of 30%. METHODS: i) A focus group with 13 Aboriginal Immunisation Healthcare Workers; and ii) a cross-sectional survey of Aboriginal people aged ≥18 years at the 2017 New South Wales Koori Knockout (29 September-2 October). RESULTS: The focus group nominated poor identification of Aboriginality in general practice. Of 273 survey respondents, a substantial minority (30%) were unaware of their eligibility for free influenza vaccination. More than half (52%) believed the vaccine could cause influenza, 40% reported there were better ways than vaccination for avoiding infection and 30% said they would not have the vaccine if it was offered to them. Regarding health service access, few reported experiencing difficulty (17%), feeling uncomfortable (15%) or being discriminated against (8%), but 53% reported not receiving a reminder from a health professional. CONCLUSIONS: Misconceptions about influenza disease and vaccine among Aboriginal people and inadequate identification of Aboriginality in general practice appear to be the greatest barriers to vaccination, rather than health service access in general. Implications for public health: More active communication to and targeting of Aboriginal adults is required; this is even more urgent following the arrival of COVID-19.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Medicina Geral , Pessoal de Saúde , Serviços de Saúde do Indígena/organização & administração , Humanos , Programas de Imunização , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos/psicologia , Cobertura Vacinal
17.
PLoS One ; 15(6): e0233972, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32492049

RESUMO

BACKGROUND: The study of oral health literacy (OHL) is likely to gain new and interesting insights with the use of network analysis, a powerful analytical tool that allows the investigation of complex systems of relationships. Our aim was to investigate the relationships between oral health literacy and oral health-related factors in a sample of Indigenous Australian adults using a network analysis approach. METHODS: Data from 400 Indigenous Australian adults was used to estimate four regularised partial correlation networks. Initially, a network with the 14 items of the Health Literacy in Dentistry scale (HeLD-14) was estimated. In a second step, psychosocial, sociodemographic and oral health-related factors were included in the network. Finally, two networks were estimated for participants with high and low oral health literacy. Participants were categorised into 'high' or 'low' OHL networks based on a median split. Centrality measures, clustering coefficients, network stability, and edge accuracy were evaluated. A permutation-based test was used to test differences between networks. RESULTS: Solid connections among HeLD-14 items followed the structure of theoretical domains across all networks. Oral health-related self-efficacy, sporting activities, and self-rated oral health status were the strongest positively associated nodes with items of the HeLD-14 scale. HeLD-14 items were the four most central nodes in both HeLD-14 + covariates network and high OHL network, but not in the low OHL network. Differences between high and low OHL models were observed in terms of overall network structure, edge weight, and clustering coefficient. CONCLUSION: Network models captured the dynamic relationships between oral health literacy and psychosocial, sociodemographic and oral health-related factors. Discussion on the implications of these findings for informing the development of targeted interventions to improve oral health literacy is presented.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde/estatística & dados numéricos , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Adulto , Austrália , Estudos Transversais , Interpretação Estatística de Dados , Feminino , Promoção da Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos/psicologia , Fatores Socioeconômicos , Adulto Jovem
18.
AIDS Educ Prev ; 32(2): 117-136, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32539477

RESUMO

Very few studies have been conducted to investigate HIV risk and protective behaviors in relation to psychosocial factors among Asian and Pacific Islander (API) MSM whose HIV/AIDS prevalence is lower than those of other racial/ethnic groups. This study, based on an online survey targeting API MSM in California revealed that API MSM often met sex partners online and that psychosocial factors (e.g., homophobia and identity with API gay community) were correlated with condomless receptive anal sex (RAS) with casual partners. In particular, an Asian cultural construct, interdependency, was correlated with condom use for RAS; that is, those who consider sex partners' health and value harmony tend to engage in safe sex. This finding sheds light on re-thinking the current over-emphasis on assertiveness and self-responsibility to keep free from HIV/STIs during negotiation with partners. Future STI prevention programs for API MSM should incorporate Asian cultural constructs and target specific risk groups.


Assuntos
Americanos Asiáticos/estatística & dados numéricos , Infecções por HIV/epidemiologia , Homossexualidade Masculina/psicologia , Internet , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Sexo Seguro/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Americanos Asiáticos/psicologia , California/epidemiologia , Infecções por HIV/psicologia , Homossexualidade Masculina/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos/psicologia , Prevalência , Assunção de Riscos , Sexo Seguro/psicologia , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/psicologia , Inquéritos e Questionários , Adulto Jovem
19.
PLoS One ; 15(6): e0234346, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32530934

RESUMO

BACKGROUND: The two part Kimberley Mum's Mood Scale (KMMS) has been developed and validated as a culturally appropriate perinatal depression and anxiety screening tool for Aboriginal women living in the sparsely populated Kimberley region of North West Australia. As part of implementation aspects of user acceptability were explored to improve clinical utilisation of the KMMS. METHODS: Eighteen health professionals involved in perinatal care participated in an online survey or a qualitative semi-structured interview. Ten Aboriginal women (who held administrative, professional or executive roles) were subsequently interviewed in depth to further explore aspects of KMMS user acceptability. RESULTS: Many of the health professionals were not using the second part of the KMMS (the psychosocial discussion tool). Time constraints and a perception that the KMMS is only appropriate for women with literacy issues were identified by health professionals as significant barriers to KMMS uptake. In contrast the Aboriginal women interviewed considered the KMMS to be important for literate Aboriginal women and placed high value on having the time and space to 'yarn' with health professionals about issues that are important to them. CONCLUSION: Implementing the KMMS across the Kimberley region requires health professionals to be trained. It also requires strategic engagement with health services to ensure health professionals and mangers understand the rationale and significance of the KMMS and are engaged in its successful implementation.


Assuntos
Afeto , Saúde Mental , Grupo com Ancestrais Oceânicos/psicologia , Assistência Perinatal/métodos , Escalas de Graduação Psiquiátrica , Adulto , Ansiedade/complicações , Ansiedade/diagnóstico , Assistência à Saúde Culturalmente Competente , Depressão/complicações , Depressão/diagnóstico , Feminino , Pessoal de Saúde , Humanos , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/psicologia , Austrália Ocidental , Adulto Jovem
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