Indigenous Stakeholders Research Articles

Exploring Climate Change Adaptations for Cultural Heritage: The ADAPT Framework

Abstract There is an urgent need for climate change–informed decision-making and adaptation actions for cultural heritage. Challenges arise in incorporating and balancing multiple considerations, including robust understandings of climate change vulnerability, the objectives of current management paradigms, the need for meaningful engagement, the risk of maladaptation, and constrained resources to implement. We offer a conceptual framework and guide to integrate climate science and cultural heritage management to produce a range of adaptation actions for cultural heritage, categorized as Acclimate, Dislocate, Abandon, Protect, and Tell the Story (ADAPT) approaches. The ADAPT framework is intended to aid archaeologists and other cultural heritage managers in developing and evaluating possible adaptation actions that directly respond to findings from climate change vulnerability assessments, critically integrating management postures and constraints, and coproducing climate change adaptations with Indigenous rightsholders and community stakeholders.

Co-designing Culturally Safe Indigenous Birth in High-Risk Obstetrics: Implementing Joyce's Principle with Inuit and Cree Families and Their Medical Providers.

Introduction. Maternal evacuation-the transfer of women from remote communities to urban hospitals for childbirth-negatively affects many Indigenous Peoples in Canada. A working group of perinatal service providers in Montreal sought to enhance cultural safety in a high-risk obstetrical unit serving evacuee Indigenous families. This article describes co-design, implementation, and evaluation of short-term cultural safety interventions with Indigenous stakeholders. Methods. Indigenous families and their non-Indigenous service providers displayed their recommendations for culturally safe birth using fuzzy cognitive mapping (FCMs). Joyce's Principle-a framework for securing culturally safe healthcare for Indigenous Peoples-guided their implementation. Results. Four high-priority FCM recommendations included an Indigenous-led cultural safety training for hospital staff. Third party evaluation showed a positive influence on cultural safety knowledge and actions. Discussion. Health services designed with Indigenous stakeholders in accordance with Joyce's Principle have the potential to enhance cultural safety of maternal evacuation.

Iman Peoples Water Sovereignty: Extractive Industries in Central Queensland

The coal seam gas (CSG) industry has rapidly expanded in the Great Artesian Basin (GAB) over the past two decades, significantly impacting groundwater ecosystems and Indigenous communities that rely on these water sources for cultural, spiritual, and practical purposes. This article examines the intersection of Water Sovereignty, extractive industries, and key issues such as Social License to Operate (SLO), Indigenous Peoples' rights, informed consent, and the legal doctrine of Aqua Nullius. Through an Indigenous perspective, this research illuminates the multifaceted dimensions of water governance and the complexities that arise from the interactions between Indigenous stakeholders, industries, and regulatory frameworks. Through interviews with Elders of the Iman Peoples in central Queensland, the research highlights how current SLO frameworks neglect Free, Prior, and Informed Consent (FPIC) and fail to uphold ethical standards necessary for protecting Indigenous cultural continuity. Water security is a primary concern, with Traditional Owners emphasizing the need to safeguard surface and groundwater for future generations. This research informs policy at local and national levels while contributing to global discussions on Indigenous sovereignty, environmental justice, and cultural heritage protection. It calls for integrating Indigenous knowledge and rights into water governance, promoting respect, equity, and sustainability in managing natural resources.

Traditional healing and medicine in dementia care for Indigenous populations in North America, Australia, and New Zealand: Exploring culturally-safe dementia care policy from a global perspective.

In 2018, the World Health Organization recognized traditional healers as community stakeholders in dementia care. This scoping review aimed to summarize the existing dementia care literature regarding strategies for the integration of traditional healing in dementia care and the roles of traditional healers. A group of Indigenous Elders from Northern Ontario, Canada, guided, reviewed, and validated the research process and findings. The Joanna Briggs Institute approach was applied to a structured search strategy across the CINAHL, Embase, MEDLINE, and PsycINFO databases. A title and abstract screening were completed, followed by a full-text assessment of the identified manuscripts. A total of 143 full manuscripts were reviewed, of which two studies fully met the community-determined inclusion/exclusion criteria. The integration of traditional healing practices into dementia care offers a pathway to culturally-safe care for people with dementia. The findings identified policy advocacy as key to engage, educate, and empower traditional healers. The WHO recognized traditional healers as community stakeholders in dementia care and prevention worldwide in 2018; however, traditional healers are underrepresented and marginalized in healthcare systems due to the lack of culturally-safe dementia care (CSDC) policies at community and national levels globally.Community-based CSDC models were critically reviewed and validated by local Indigenous community stakeholder consultations.The result is a call to action to assist the WHO and Alzheimer's Disease International in developing guidelines for CSDC policy improvements with the global Indigenous community for the engagement and empowerment of traditional healers to navigate dementia care and to implement the WHO Global Action Plan on the Public Health Response to Dementia (2017-2025).Integration of Western biomedical and Indigenous traditional healing and medicine in dementia care in the healthcare system can reduce health disparities and empower traditional healers on a global scale. Indigenous-led models that include traditional healers in dementia care are critical for improving equity gaps in dementia care for Indigenous Peoples.

Dams, dams and more dams: Issues in evaluating business cases for dam expansion in Australia

Abstract Conventional interventions for mitigating flood risk and increasing water security often focus on large-scale engineering solutions despite evidence of significant cost overruns and negative environmental impacts. This study is an example of participatory research in water economics, motivated (and requested) by concerns from downstream communities and Indigenous stakeholders that impacts of a proposed dam upgrade and storage increase were not adequately considered. We reviewed the preliminary benefit-cost analysis (BCA) of the proposed AUD$2.1 billion investment to expand the Wyangala Dam in Australia and conducted a new BCA incorporating downstream community perspectives. The original economic analysis favoured the proposed investment, but it underestimated costs and overestimated benefits. Our economic analysis was complemented with a qualitative analysis of downstream community perspectives, plus a quantitative analysis indicating that project costs were underestimated by a minimum of 116%. In comparison, benefits were overestimated by 56%. Neglecting the potential impact of climate change also severely overestimated the original benefit-cost ratio. Based on our calculations, expanding the dam was unlikely to yield a net social benefit. In 2023, a new government decided the dam expansion was too expensive. We recommend policymakers prioritise independent evaluations and community engagement for BCAs on large-scale water infrastructure projects to ensure equitable investment decisions that maximise social welfare and adequate environmental assessment.

Environmental degradation, climate change and health from the perspective of Brazilian Indigenous stakeholders: a qualitative study

BackgroundThe WHO identifies climate change as the most significant threat to global health systems. Indigenous peoples, whose lives are deeply intertwined with nature, are particularly vulnerable to the impacts of...

Continuity or Disruption? Rethinking Engagement in Multi-Stakeholder Forums Through the Lens of Boundary Objects

Multi-stakeholder forums (MSFs) are crucial for managing complex decision-making; yet ways for evaluating engagement, especially for Indigenous peoples, remain ambiguous. This study examines the Honduran Mosquitia, where conflict over the illegal occupation of Indigenous lands led to the creation and eventual dissolution of an MSF. It questions whether the continuity of formal dialogue structures signifies genuine engagement or if disruption might better indicate it. The study applies the lens of boundary objects—concepts or devices that enable collaboration among actors with differing agendas—to assess engagement. In Mosquitia, territorial governance served as a boundary object, fostering the establishment of an MSF. Government, donor, and Indigenous stakeholders had their distinct interests in supporting territorial governance. Indigenous stakeholders exited the MSF when their aims for securing land tenure were unmet, turning to civil disobedience to assert territorial governance. The MSF’s dissolution prevented the co-optation of territorial governance by government and donors, remaining a contentious term that more accurately reflected the tensions among stakeholders. This case shows how engagement might paradoxically be reflected in the MSF’s disruption.

On Micropolitics: Climate adaptation and Indigenous governance in Western Alaska

Climate adaptation for Indigenous communities is not as simple as making good policy; it is equally about how policy is implemented and how collaboration unfolds between settler governments and Indigenous stakeholders. Rural Alaska Native villages are among the most environmentally threatened communities in the United States. Their ability to effectively manage environmental change and preserve sovereignty depends upon successful collaboration with a range of stakeholders, especially federal agencies. For more than two decades, academics and government agencies have documented a consistent pattern of failures, particularly by federal actors, to effectively manage adaptation challenges. These obstacles are sometimes misrepresented as policy failures. While poor policy is certainly involved in these poor outcomes, this paper highlights a set of barriers to successful collaboration that are not policy issues, per se, but rather micropolitical issues; that is, they pertain to the conduct of government in the context of Tribal relationships. Unaddressed, these micropolitical issues have created obstacles to Alaska Native communities’ self-determination as they adapt to a changing landscape. These barriers are explored in a case study drawn from Typhoon Merbok, which struck Western Alaska in 2022, and empirically grounded in a series of interviews and participant observation with experts, elders, elected officials, and Tribal staff. This article concludes with several concrete recommendations to improve the practice of domestic diplomacy between Indigenous communities and colonial governments.

The cultural safety of research reports on primary healthcare use by Indigenous Peoples: a systematic review

IntroductionCommunity-driven research in primary healthcare (PHC) may reduce the chronic disease burden in Indigenous peoples. This systematic review assessed the cultural safety of reports of research on PHC use by Indigenous peoples from four countries with similar colonial histories.MethodsMedline, CINAHL and Embase were all systematically searched from 1st January 2002 to 4th April 2023. Papers were included if they were original studies, published in English and included data (quantitative, qualitative and/or mixed methods) on primary healthcare use for chronic disease (chronic kidney disease, cardiovascular disease and/or diabetes mellitus) by Indigenous Peoples from Western colonial countries. Study screening and data extraction were undertaken independently by two authors, at least one of whom was Indigenous. The baseline characteristics of the papers were analyzed using descriptive statistics. Aspects of cultural safety of the research papers were assessed using two quality appraisal tools: the CONSIDER tool and the CREATE tool (subset analysis). This systematic review was conducted in accordance with the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool.ResultsWe identified 35 papers from Australia, New Zealand, Canada, and the United States. Most papers were quantitative (n = 21) and included data on 42,438 people. Cultural safety across the included papers varied significantly with gaps in adequate reporting of research partnerships, provision of clear collective consent from participants and Indigenous research governance throughout the research process, particularly in dissemination. The majority of the papers (94%, 33/35) stated that research aims emerged from communities or empirical evidence. We also found that 71.4% (25/35) of papers reported of using strengths-based approaches by considering the impacts of colonization on reduced primary healthcare access.ConclusionResearch on Indigenous PHC use should adopt more culturally safe ways of providing care and producing research outputs which are relevant to community needs by privileging Indigenous voices throughout the research process including dissemination. Indigenous stakeholders should participate more formally and explicitly throughout the process to guide research practices, inclusive of Indigenous values and community needs.

Cross-cultural visual anthropology: Beyond repatriation, exploring indigenous and non-indigenous exchanges

Collaboration is critical concept in Arctic anthropology, in which indigenous people participate not just as research subjects but as collaborative partners in advancing scientific knowledge. The trans-disciplinary approach develops new conceptual, theoretical, and methodological innovations that transcend discipline-specific boundaries. Such innovations facilitate engagement between indigenous and non-indigenous stakeholders in addressing real-world challenges. This paper documents several Siberian ethnography exhibitions organized by the authors and evaluates their anthropological and social significance. Historically, anthropological discourse has championed using visual materials as tools for cultural interventions aimed at societal transformation. Building upon this foundation, this study explores the challenges of both the Russian Arctic and Asian contexts. The article guides the readers to reconsider conventional anthropological perspectives and methods of collaborating both with the indigenous and non-indigenous partners. By outlining the authors experiences in involving local stakeholders across different countries in these exhibitions, they illuminate the impact of the exhibitions on diverse cultural contexts. As cross-cultural visual anthropology endeavors, the exhibits redefine the meaning of ethnographical snapshots as scientific knowledge and go beyond repatriating indigenous cultures or sharing research outcomes with the broader society. The cross-cultural exhibition is becoming a novel research modality and a tool for fostering social interactions.

The Influence of Agrosilvopasture Implementation and MSME Incubation on SDGs with Financial Literacy Mediation in Rural Areas of Indonesia

This research explores the roles of Agrosilvopasture, MSME Incubation, and financial literacy in supporting Sustainable Development Goals (SDGs) in rural Indonesia. Conducted from April to September 2023 in Pagar Alam City, the study involves the participation of indigenous communities and stakeholders associated with customary forest management, comprising 100 intentionally selected respondents. The Slovin formula was employed to determine the number of respondents in the sample, who were then selected using a purposive sampling technique from the community of customary forest managers in Mude Ayek Tebat Benawa. The research investigates the relationships among variables: Implementation of Agrosilvopasture (X1), MSME Incubation (X2), Financial Literacy (M), and SDGs (Y). Path coefficient analysis reveals that Agrosilvopasture has a significant negative influence on Financial Literacy but a positive impact on SDGs. The analytical tool utilized is Partial Least Squares-SmartPLS. MSME Incubation yields a favorable impact on both Financial Literacy and SDGs. Financial literacy, consequently, has a beneficial impact on the SDGs. Mediation testing validates that Financial Literacy serves as a mediator in the relationship between Agrosilvopasture and the examined outcomes. MSME Incubation, and SDGs. In conclusion, financial literacy, Agrosilvopasture implementation, and MSME Incubation are crucial for achieving SDGs in rural areas. These holistic approaches offer promising pathways to achieve various SDGs, and in enhancing the effectiveness of these strategies financial literacy plays a pivotal role.

The Use of Indigenous Knowledge Systems Practices to Enhance Food Security in Vhembe District, South Africa

This paper seeks to examine how subsistence farmers employ indigenous knowledge methods to enhance food security within rural communities in the Vhembe district. It analyses indigenous knowledge practices used in managing climate change impacts on crop production and determines indigenous knowledge processes used to preserve food to fill the gap during food shortages. The paper also considers the indigenous weather prediction approaches used in the area. A participatory rural appraisal is complemented by a qualitative and quantitative approach. This study used semi-structured interviews, questionnaires and focus group discussions for data collection. A survey of 200 randomly selected indigenous farmers was sampled. The finding revealed that local farmers depend on the use of indigenous knowledge practices to improve household food security. The majority of farmers apply manure in their farms using livestock dumps. Also, it shows that 87.8% of households used sun-drying processes for food preservation and used local mortars to pound and grind foodstuffs such as peanuts and maize. Practices such as crop rotations, mixed cropping and intercropping were employed to improve soil fertility and climate change and reduce insect pest outbursts on crops, hence, improving crop production. Indigenous knowledge of rainfall prediction is helpful in preparation for the planting season. The study recommended that agriculture policies must acknowledge indigenous knowledge practices in development programmes and specific policy interventions to promote the indigenous knowledge systems must focus on enhancing socio-economic factors assisting farmers in improving post-harvest storage facilities. The findings could facilitate interaction between indigenous knowledge stakeholders and the Limpopo provincial agriculture training institution. The fulfilment of the United Nations Sustainable Development Goal 2 on zero hunger and food security could benefit from the indigenous knowledge systems.

Technology adoption among Indigenous tourism stakeholders: scale development and validation

ABSTRACT Technology adoption among indigenous tourism stakeholders is nascent and has not gained momentum due to inherent and exogenous constraints. As the role of information technology (IT) for development is well evidenced in the tourism sector, encouraging its adoption among all stakeholders is mandated. Developing a reliable and valid scale with appropriate psychometric properties to measure factors affecting technology adoption among Indigenous tourism stakeholders amidst constraints thus assumes significance. The study employed an exploratory sequential method. The result shows four latent constructs, i.e. cognitive, facilitation, institutional, and customer-centric, consisting of 22 variables explaining factors affecting technology adoption among Indigenous tourism stakeholders. The study contributes to the need for a reliable scale to measure factors affecting technology adoption among Indigenous tourism stakeholders, offering insights crucial for policy-making and strategy development, fostering grassroots-level economic development through IT-enabled initiatives.

Climate services for agriculture: Steering towards inclusive innovation in Australian climate services design and delivery

CONTEXTClimate services are integral to climate change adaptation in agriculture. Inclusive innovation prioritises inclusion of marginalised actors, grassroots knowledge and accessibility of use. Yet many innovation processes are multi-stakeholder, complex and may not prioritise inclusion from the outset. In these circumstances, researchers and designers may seek to influence existing projects towards greater inclusivity. OBJECTIVESThis paper explores efforts to increase the inclusivity of existing innovation processes, focusing on the design of My Climate View, an online Australian climate services platform for agriculture. Findings relate to contemporary issues in inclusive innovation literature, including: (1) Who should be included in innovation processes (within given resourcing)?; (2) How requirements for inclusion or exclusion can emerge through the design and use of a technology; and (3) The influence of program level structures upon inclusivity and design. METHODSOur approach is informed by Responsible Innovation and Inclusive Innovation theory and enacted through user-centred design. Findings are synthesised from analysis of 60 semi-structured interviews with farmers, advisors and extension officers. We additionally draw on observations as researchers in the multi-actor My Climate View development team, where extensive engagement separate to research activities has included agricultural and Indigenous stakeholders. RESULTS AND CONCLUSIONEngaging with a broad sample of potential target users enabled diverse and sometimes unexpected use cases. Customisation of interface parameters allowed the incorporation of tacit knowledge and positively affected the inclusivity of My Climate View, extending the value of the platform to growers of niche commodities outside of the original scope. Inclusivity in innovation can be impacted by diverse factors, including design team decisions, structural factors, budget and external factors. Requirements for inclusion and exclusion can emerge and evolve throughout a design process, supporting Responsible Innovation's framing of inclusivity alongside principles of reflexivity and responsiveness. SIGNIFICANCEThe findings enrich the evidence base for climate services and broader agricultural technology development processes by providing insights for those seeking greater impact by practicing inclusivity in innovation. We provide four implications for increasing inclusivity in the design of climate services: (1) Maximising customisation and avoiding prescriptive interpretation enables greater flexibility of use; (2) Sampling broadly within target users to uncover unanticipated values and opportunities for inclusion and exclusion; (3) It is important to embed efforts towards inclusion alongside processes of reflexivity; and (4) Responsible and inclusive approaches to climate services design are valuable even if brought in once development has commenced.

The Utility of Data Collected as Part of Australia's Aboriginal and Torres Strait Islander Health Performance Framework.

Since 2006, the Australian Aboriginal and Torres Strait Islander Health Performance Framework (HPF) reports have provided information about Indigenous Australians' health outcomes. The HPF was designed, in consultation with Indigenous stakeholder groups, to promote accountability and inform policy and research. This paper explores bridging the HPF as a theoretical construct and the publicly available data provided against its measures. A whole-of-framework, whole-of-system monitoring perspective was taken to summarise 289 eligible indicators at the state/territory level, organised by the HPF's tier and group hierarchy. Data accompanying the 2017 and 2020 reports were used to compute improvement over time. Unit change and confidence indicators were developed to create an abstract but interpretable improvement score suitable for aggregation and visualisation at scale. The result is an exploratory methodology that summarises changes over time. An example dashboard visualisation is presented. The use of secondary data inevitably invites acknowledgments of what analysis cannot say, owing to methods of collection, sampling bias, or unobserved variables and the standard mantra regarding correlation not being causation (though no attempt has been made here to infer relationships between indicators, groups, or tiers). The analysis presented questions the utility of the HPF to inform healthcare reform.

Indigenous peoples at the heritage–climate change nexus: Examining the effectiveness of UNESCO and the IPCC’s boundary work

Abstract There is increasing recognition that Indigenous knowledges have considerable potential to enhance collective understandings of and improve responses to complex ecological threats, such as those to cultural heritage from climate change. At the same time, it appears that Indigenous peoples face structural barriers to participation in international organisations that advance knowledge about those problems. Using the conceptual framework of boundary organisations (BOs) theory and case studies of the Intergovernmental Panel on Climate Change (IPCC) and UNESCO, I argue that the lack of meaningful Indigenous engagement in international knowledge institutions is not just an ethical problem; it also undermines the effectiveness of their assessments. The future success of their boundary work partly depends on further engagement with Indigenous stakeholders. At least at the heritage–climate change nexus, the salience, legitimacy, and credibility of IPCC and UNESCO assessments require substantive Indigenous representation alongside other state/non-state parties. Successful experiences in biodiversity governance indicate that incorporating the principles of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) would enhance Indigenous engagement in UNESCO and the IPCC.

‘We know what our communities need’: What the Indigenous health sector reveals about pandemic preparedness in urban Indigenous communities in Australia

PurposeIn 2021, during the height of the COVID-19 pandemic, researchers from the University of Queensland sought greater understanding of how responses to the pandemic impacted the spread or mitigation of virus in Indigenous communities in southeast Queensland, Australia. This article used a systems thinking methodology to critically unpack the strengths and challenges associated with pandemic responses during COVID-19 in urban Brisbane, Australia. MethodsThe findings from three Indigenous-led workshops held in 2020 with Indigenous and non-Indigenous stakeholders from the urban health sector were documented. By visually mapping the dynamics that influence the outcomes of health responses, this study found that holistic understandings of complex problems such as COVID-19 can be gained, and more effective policy implemented. Drawing on the insights provided by stakeholders from state, federal and community representative bodies, it discussed how infection rates, socioeconomic conditions, age-specific responses, Indigenous participation and treatment in the workforce, media and communications, and vaccinations are key determinants that shape positive or adverse outcomes during pandemics. Main findingsThis research found by addressing issues relating to mobility; incentivising protective behaviours; engaging in coordinated responses; improving cultural literacy; and limiting overcrowding that preparedness and responses to COVID-19 and future pandemics may improve. Principal conclusionThis study, led by Indigenous scholars at the University of Queensland, examines the health and social outcomes of Indigenous peoples and health workers during pandemics in urban settings. The study incorporates systems thinking, emphasising new approaches to complex problems. The research highlighted systemic challenges in pandemic responses, emphasising the need for policy reform, particularly in areas like housing. However, applying these insights into practice remains challenging, and further investigation into the practical application of systems thinking in Indigenous health is needed.

Collaboration with Indigenous communities in an integrated care learning health system in Ontario, Canada: a case study of the Frontenac, Lennox & Addington Ontario Health Team

Context: Health systems in the province of Ontario in Canada have been restructured into Ontario Health Teams (OHTs). OHTs seek to provide integrated care through improving patient experience, improving care provider experience, improving population health outcomes, reducing costs, and addressing health equity - per the Quintuple Aim framework. The Frontenac, Lennox & Addington (FLA) OHT was created in bringing together numerous clinical and community partners, including local Indigenous health groups. Indigenous peoples face health inequities driven by colonization and systematic racism; improving accessibility, cultural appropriateness, and cultural safety of health systems are essential. To ensure that unique needs of Indigenous peoples are met, there should be a collaborative, participatory approach to planning and executing Indigenous-specific evaluation activities, with Indigenous-specific performance indicators.
 Objectives: 1) To co-design, implement, and evaluate a governance process for collaboration with Indigenous communities, for Indigenous-focussed evaluation of FLA OHT activities. 2) To nest the above into a case study of the FLA OHT, examining processes for centering Indigenous perspectives and priorities in systems evaluation. 
 Study Design: Case study method involving community-based participatory research (CBPR), and using principles of Ownership, Control, Access, Possession (OCAP) in ethical Indigenous health research. The research team involves Indigenous members of FLA OHT working groups and tables, other partners and stakeholders from the broader Indigenous communities of the region, Queen’s University (Kingston, Ontario) researchers on the FLA OHT’s evaluation support structure, and other FLA OHT team members. Data used for the case study include focus groups and interviews with Indigenous members, analysis of meeting minutes and other relevant organizational documents, and surveys on team function and Indigenous-specific evaluation activities. Indigenous-specific indicators have been identified through rapid literature reviews and are being incorporated into logic models for evaluation of FLA OHT projects.
 Expected Outcomes: 1) A framework to operationalize collaboration between Indigenous stakeholders and mainstream health systems, in the co-design and co-execution of health system evaluation approaches that reflect Indigenous perspectives and priorities. 2) Incorporation of Indigenous-specific evaluation activities for FLA OHT projects.
 Results: Work in progress at time of abstract submission.
 Conclusions: The framework produced will serve as a practical, operationalized guide to other mainstream health systems and Indigenous groups seeking to collaborate together. The Indigenous-specific evaluation activities will enable thoughtful and rigorous consideration of whether the needs of Indigenous patients and communities are met, and allow for modification of programs and services – per the “learning health system” goal of iterative knowledge production and action to drive continuous improvement. Additionally, this project will strengthen relationships between the region’s mainstream service organizations, policymakers, Queen’s University academic researchers, and local Indigenous peoples. Strengthened relationships will facilitate current and future collaborative work to improve systems, as a step towards addressing health inequities facing Indigenous peoples.

Indigenous identity identification in administrative health care data globally: A scoping review.

Both Indigenous and non-Indigenous governments and organizations have increasingly called for improved Indigenous health data in order to improve health equity among Indigenous peoples. This scoping review identifies best practices, potential consequences and barriers for advancing Indigenous health data and Indigenous data sovereignty globally. A scoping review was conducted to capture the breadth and nature of the academic and grey literature. We searched academic databases for academic records published between 2000 and 2021. We used Google to conduct a review of the grey literature. We applied Harfield's Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT) to all original research articles included in the review to assess the quality of health information from an Indigenous perspective. In total, 77 academic articles and 49 grey literature records were included. Much of the academic literature was published in the last 12years, demonstrating a more recent interest in Indigenous health data. Overall, we identified two ways for Indigenous health data to be retrieved. The first approach is health care organizations asking clients to voluntarily self-identify as Indigenous. The other approach is through data linkage. Both approaches to improving Indigenous health data require awareness of the intergenerational consequences of settler colonialism along with a general mistrust in health care systems among Indigenous peoples. This context also presents special considerations for health care systems that wish to engage with Indigenous communities around the intention, purpose, and uses of the identification of Indigenous status in administrative databases and in health care settings. Partnerships with local Indigenous nations should be developed prior to the systematic collection of Indigenous identifiers in health administrative data. The QAT revealed that many research articles do not include adequate information to describe how Indigenous communities and stakeholders have been involved in this research. There is consensus within the academic literature that improving Indigenous health should be of high priority for health care systems globally. To address data disparities, governments and health organizations are encouraged to work in collaboration with local Indigenous nations and stakeholders at every step from conceptualization, data collection, analysis, to ownership. This finding highlights the need for future research to provide transparent explanation of how meaningful Indigenous collaboration is achieved in their research.

Responding to COVID‐19: How group model building can assist the health and well‐being of urban Indigenous communities in Australia

AbstractIn this paper, we discuss a rapid‐fire study involving Indigenous and non‐Indigenous stakeholders from the urban Indigenous health sector who collaborated to produce an “Urban COVID‐19 Systems Map.” The map outlines the behaviours, actions and responses that stakeholders identified as mitigating or exacerbating COVID‐19 risks in urban Indigenous communities. Data were collected and analysed during the height of the pandemic in 2021. We begin by introducing the characteristics of system thinking—the methodology that informed our research—and consider its use in Indigenous health research more broadly. We then outline our utilisation of system thinking and discuss how it was applied to the three workshops. System thinking contributes to collaboration and collective debate amongst stakeholders and aims to produce holistic understandings of complex problems, such as pandemics. This article provides a reflective overview of the benefits and challenges of applying system thinking in Indigenous health research whilst also sharing some of the research findings. We argue that centralising the voices of stakeholders, particularly Indigenous stakeholders, is critical to developing and implementing effective and culturally appropriate responses to pandemics and is equally as important to the preparedness for future pandemics.