Aboriginal Health
The National Centre in HIV Social Research does not have a formally constituted research program in Aboriginal health. However, given our commitment to working with communities affected by HIV, hepatitis C and sexually transmissible infections, we have become involved in and initiated a number of projects working with Aboriginal health organisations and communities. These collaborative projects explore issues such as the knowledge of blood-borne viruses among Aboriginal people, access to services, resilience and child health, and the experience of cancer among Aboriginal Australians. It is vital that research with Aboriginal people be equitable, transparent, deliver community benefits and meet the highest ethical standards. For these reasons we work closely with Aboriginal health organisations to develop research protocols of benefit to all stakeholders.
Current projects and contacts
- Sexual health and relationships in young Indigenous people
- SEARCH: study of environment on Aboriginal resilience and child health: for more information please contact, Professor Susan Kippax.
- Aboriginal patterns of cancer care (APOCC): for more information please contact, Dr Loren Brener.
- Building research capacity for health interventions to imporve Aboriginal health
Selected past projects
- Survey of knowledge, risk practice and access to services in Aboriginal people in New South Wales: for more information please contact Dr Joanne Bryant
- Cancer in Aboriginal people
- Aboriginal people living with HIV in urban and rural settings in Western Australia
Project Descriptions
Sexual health and relationships in young Indigenous people
Bryant and Hull
Despite higher notified rates of sexually transmissible infections and blood borne viruses and often negative depictions of young indigenous people, very little is known of the health and well being of young Indigenous people. This project will provide the first national profile of risk behaviours, levels of knowledge and the types of health services young Indigenous people access for sexual health and blood borne viruses. The project is funded by an Australian Research Council Linkage grant and will be conducted with co-investigators at the National Centre in HIV Epidemiology and Clinical Research, the Australian Research Centre in Sex Health and Society, and the National Aboriginal Community Controlled Health Organisation. The project builds on a past project conducted by the National Centre in HIV Social Research among young indigenous people in New South Wales. The findings of this research will set the foundations for a longer term strategy to ensure trends and behaviours can be identified among the population and where necessary interventions can be implemented.
Study of environment on Aboriginal resilience and child health (SEARCH)
This project involves the establishing of a cohort of Aboriginal families with children aged 16 years and under to investigate over a twenty-year period the causes of health and illness with a focus on physical, community and family environments. It aims to investigate the relationship between a healthy environment and a range of health outcomes in Aboriginal children and young people living in urban areas, and the impact of a community led program on the development of healthy environments and the health of children. Information will be collected using a variety of measures including: observational measures of housing quality and safety; survey and questionnaire assessments of self-reported health, resilience, social and emotional well-being, family structure, social support and community engagement; and medical records from Aboriginal medical services. The input of NCHSR will be focused on resilience and its correlates.
In 2007 the questionnaire was designed and approval sought and gained from Aboriginal medical services. Discussions with communities indicated that within existing resource constraints it would be possible to recruit 400 families. Data collection began in late 2007; however, new recruitment strategies are being trialled to improve access to families.
Aboriginal patterns of cancer care (APOCC)
Kippax, Treloar, Brener, Ellard and Newman
The aims of the APOCC study are to assess whether or not Aboriginal people are being diagnosed with cancer at later stages than non-Aboriginal people and, if so, to describe both the barriers to early diagnosis and access to cancer care experienced by Aboriginal people and the care that Aboriginal people with cancer are currently receiving; and to compare the level and type of care they receive with that received by non-Aboriginal people.
The research is funded by the National Health and Medical Research Council on a Health Services Grant and administered by The Cancer Council New South Wales. This research consists of four phases. NCHSR is responsible for the qualitative arm of the research, which entails conducting in-depth interviews with 50 Aboriginal people with cancer, 30 carers of Aboriginal people with cancer and 30 health care workers who work with Aboriginal people with cancer. The qualitative arm aims to explore and understand Aboriginal people’s cancer journey using culturally appropriate qualitative research tools. The other three phases of the study are: i) a description of patterns of cancer treatment given to Aboriginal in-patients, using linked data from the New South Wales Central Cancer Registry and the Inpatient Statistics Collection of records of hospital admissions in New South Wales; ii) validation and expansion of the data from the analysis of the in-patient statistics by means of abstraction of treatment information from medical records at Aboriginal medical services; and iii) population-based studies of the patterns of care and pathways to diagnosis for Aboriginal people with cancer.
Making a difference: building research capacity for health interventions to improve Aboriginal health
NCHSR will work with Aboriginal researchers to build their research skills and their capacity to engage in qualitative research. This capacity building will be carried out in conjunction with the project Aboriginal Patterns of Cancer Care, which is run by The Cancer Council New South Wales in conjunction with NCHSR and researchers from the University of Sydney.
Past project descriptions
Survey of knowledge, risk practice and access to services among Aboriginal people in New South Wales
NSW has the highest proportion of Aboriginal people in Australia, yet there is little or no information about levels of sexually transmissible infections (STI) and blood borne viruses (BBV) in the NSW Aboriginal population. Evidence from other Australian states indicates the prevalence of STIs amongst Aboriginal and Torres Strait Islander (ATSI) people to be up to eight times higher than for the non-indigenous population. Despite this, very little culturally appropriate research has been conducted with ATSI communities about sexual health and blood borne viruses, especially compared with other priority population groups such as gay men and injecting drug users. This project was conducted through a unique partnership between the National Centre in HIV Social Research and the Aboriginal Health and Medical Research Council of NSW. It aimed to describe levels of knowledge, risk practice and access to health services in relation to STI and BBV for Aboriginal people aged 16 to 30 years in New South Wales. Convenience samples were collected at the Aboriginal Rugby League Knockout Carnival in Lismore in October 2007 and the Yabun festival in Sydney in January 2008. Data were collected using handheld computers where questions were read to the participant via headphones and answers recorded on a handset. This maximised confidentiality and countered any problems with literacy. Results from the project will be published in peer-review journals in 2009-2010.
Cancer in Aboriginal people: pilot study
A qualitative pilot study was funded by The Cancer Council Australia to develop and test research tools for a larger study on cancer in Aboriginal people in New South Wales. This pilot study established working relationships with key Aboriginal organisations, including the Aboriginal Health and Medical Research Council and the Coalition for Research to Improve Aboriginal Health (CRIAH). The study also designed and piloted interview schedules, built research capacity among Aboriginal researchers by employing and training Aboriginal interviewers, and developed and tested strategies for recruiting participants.
To ensure Aboriginal involvement in the data collection stage, the project team recruited and trained three Aboriginal people to work as interviewers on the project. The training process included a workshop on qualitative research and interviewing, observing experienced interviewers conducting interviews with health care workers and, alongside an experienced interviewer, co-interviewing Aboriginal people with cancer. It is envisaged that these Aboriginal interviewers will also be employed on the larger study.
In 2007, pilot interviews were conducted with five Aboriginal people with cancer (three women and two men) and eight health care workers (both Aboriginal and non-Aboriginal) who worked with Aboriginal people with cancer. The patients and health care workers were recruited from one urban and one regional Aboriginal community controlled health service. In 2007 a paper reviewing the literature on this topic was accepted for publication in Critical Public Health. A final report on the initial ‘pilot’ study will be completed in early 2008.
The pilot study was conducted by a research team with experience in qualitative research, cancer research and Aboriginal health research from the School of Psychology, University of Sydney; The Sax Institute; and the School of Public Health and Community Medicine and the National Centre in HIV Social Research, both at The University of New South Wales.
This pilot study has fed into a five-year project entitled Aboriginal Patterns of Cancer Care (APOCC), which isfunded by the National Health and Medical Research Council in collaboration with the University of Sydney, the Sax Institute and The Cancer Council New South Wales. This project will run from 2007 to 2011.
Aboriginal people living with HIV in urban and rural settings in Western Australia
This project was conducted by the Western Australian Department of Health with NCHSR acting as consultant and co-author on selected publications. The aim was to document, through 20 in-depth interviews, the experience of living with HIV among urban and rural Aboriginal people in Western Australia, and thereby to inform programs to reduce the social impact of HIV in Aboriginal communities.
The interviews focused on issues relating to the impact of HIV on everyday life. This qualitative study gave a voice to Aboriginal people living with HIV in Western Australia. Several journal articles have been published from the findings of the study and in 2005 two conference papers were presented.
