Longitudinal Study Of Indigenous Children Research Articles

Thriving Beyond Adversity: A Prospective Longitudinal Cohort Study Using a Strength-Based Approach Depicts Indigenous Adolescents with Less Adverse Childhood Experiences (ACEs) Had Fewer Neurodevelopmental Disorders (NDDs).

Improving social and emotional well-being (SEWB) among Indigenous adolescents is crucial. Since neurodevelopmental disorders (NDDs) are common in Indigenous people and adverse childhood experiences (ACEs) are important contributors to negative health outcomes throughout the lifespan, we investigated whether limited ACE exposure is associated with reduced risk of NDDs in Australian Indigenous teens using the data from multiple waves (Wave 1 to Wave 9, and Wave 11) of the Longitudinal Study of Indigenous Children (LSIC). We also examined the role of other protective factors, such as Indigenous cultural identity and school connectedness, against NDDs. A strengths-based approach using mixed-effects logistic regression models examined the protective effect of limited ACE exposure (from LSIC waves 1-9) on NDDs (outcome from LSIC wave 11), adjusting for sociodemographic factors. The NDDs included autism, ADHD, intellectual, neurological, and specific learning disabilities. Of the 370 individuals analysed, 73.2% valued Indigenous cultural identity, and 70.5% were strongly connected at school. More than one-fourth (27.8%) reported limited ACE exposure, while the majority was not diagnosed with NDDs (93%). Longitudinal analysis revealed limited ACE exposure was 6.01 times (95% CI: 1.26-28.61; p = 0.024) more likely to be protective against NDDs compared to those exposed to multiple ACEs. Moreover, valuing cultural identity (aOR = 2.81; 95% CI: 1.06-7.39; p = 0.038) and girls (aOR = 13.88; 95% CI: 3.06-62.84; p = 0.001) were protective against NDDs compared to their respective counterparts. Our findings highlight the need to prevent ACE exposure and promote Indigenous cultural identity in preventing negative health outcomes and the exacerbation of health inequities to strengthen the SEWB of Indigenous communities.

‘He wants to play football but not available here … ’ Parent perspectives of Aboriginal and Torres Strait Islander child physical activity and sport participation

ABSTRACT Aboriginal and Torres Strait Islander children have higher physical activity participation levels than non-Aboriginal children. However, this trend reverses in adulthood. Data came from the Longitudinal Study of Indigenous Children (LSIC) at age 8–13 years. Using conventional content analysis, interviews with primary caregivers of Aboriginal and Torres Strait Islander children were analyzed to understand current sports and physical activity participation, what children would like to do, and associated barriers. Sport (individual and team) and play were identified as important; with football and water sports most frequently mentioned as activities that children enjoy. Dancing was frequently mentioned as an activity that children enjoy and would like to participate in … These findings identify preferences for physical activity and sports participation, including activities that have cultural significance for Aboriginal and Torres Strait Islander peoples in addition to exercise. These activities can act as mediums for family, kinship, community and cultural connection.

The interactive effects of Indigenous identity and lateral violence on youth adjustment in Aboriginal and Torres Strait Islander children

ABSTRACT Objectives Lateral violence is the potential for members of a group to engage in practices that are harmful to other members of their own group. Evidence indicates that lateral violence can affect Aboriginal children’s social and emotional wellbeing (SEWB); however, little is known about the potential for ethnic-racial identity (ERI) to protect against harmful effects of lateral violence. Methods We investigated whether ERI affirmation moderated the relationship between exposure to lateral violence and Aboriginal children’s SEWB. Children (n = 360) from the K-Cohort of the Longitudinal Study of Indigenous Children were included in this analysis. Children’s ERI was dichotomised into high versus low affirmation, and General Linear Models were used to examine the effects of lateral violence on SEWB and the potentially moderating effect of ERI on that relationship. Results Increased exposure to lateral violence was associated with increased difficulties in all Strengths and Difficulties Questionnaire domains. ERI was also shown to moderate the relationship between exposure to lateral violence and peer difficulties, with children in the high ERI affirmation group showing greater vulnerability than those in the low group. Conclusions The findings of this study are discussed in relation to their potential to inform policy and clinical practice.

Mothers and sportsmen: The gendered and racialised nature of role model selection for Aboriginal and/or Torres Strait Islander youths

AbstractThis article seeks to understand who Aboriginal and Torres Strait Islander children select as role models, and the reasons underlying these choices. Drawing data from Wave 8 of the Longitudinal Study of Indigenous Children, it comprises a sample of 307 children (169 male and 138 female) aged between 10.5 and 12 years at the time of data collection. Content analysis was used to analyse survey responses regarding two questions pertaining to role models, the analytical process being underpinned by Indigenous standpoint theory. The findings show that participants tended to select role models correlating with their gender and who were Indigenous or people of colour. For boys, most selected Indigenous sportsmen, whilst girls more evenly selected mothers, women from the entertainment industry, and sportswomen. The reasons why these individuals were selected were similar for boys and girls: the role model's ability, mastery and/or competency in a given field. These findings are important for educators and schools in guiding Aboriginal and Torres Strait Islander youths in their educational and career choices, and for policymakers in creating campaigns and pathways into fields where Indigenous persons are underrepresented.

Supports desired by Aboriginal and Torres Strait Islander males in fatherhood: Focussing on the social and cultural determinates of health and well‐being

AbstractIn Australia, there is insufficient exploration and understanding of how we can strengthen the critical role played by Indigenous fathers. This paper argues that for Indigenous fathers to feel supported in childrearing, greater attention must be given to their social and cultural determinants of health and well‐being. To gain insights into the challenges experienced by Indigenous fathers and the support they require in fatherhood, we primarily apply thematic analysis to data from the Longitudinal Study of Indigenous Children (LSIC). The findings reveal that most fathers identify a social or cultural health and well‐being determinant challenging their fatherhood journey. We examine these results and suggest why and how appropriately focussing on the social and cultural determinants of health and well‐being will enhance and support Indigenous men in fatherhood.

Trajectories of otitis media and association with health determinants among Indigenous children in Australia: the Longitudinal Study of Indigenous Children

ObjectivesIndigenous children in Australia experience high burden of persistent otitis media (OM) from very early age. The aim was to identify distinct trajectories of OM in children up to age 10–12 years and examine the association with socio-economic determinants. Study designA multistage clustered national panel survey. MethodsThe study analysed the birth cohort of the Longitudinal Study of Indigenous Children from 2008 to 2018, comprising 11 study waves. Group-based trajectory modelling was used to identify different trajectories of OM outcome. Multinomial logistic regression was applied to examine the relationship between trajectories and individual, household and community-level socio-economic determinants. ResultsThis analysis included 894 children with at least three responses on OM over the 11 waves, and the baseline mean age was 15.8 months. Three different trajectories of OM were identified: non-severe OM prone, early/persistent severe OM and late-onset severe OM. Overall, 11.4% of the children had early/persistent severe OM from birth to 7.5 to nine years, while late-onset severe OM consisted of 9.8% of the children who had first OM from age 3.5 to five years. Children in communities with middle and the highest socio-economic outcomes have lower relative risk of early/persistent severe OM (adjusted relative risk ratio = 0.39, 95% confidence interval = 0.22–0.70 and adjusted relative risk ratio = 0.22, 95% confidence interval = 0.09–0.52, respectively) compared to children in communities with lowest socio-economic outcomes. ConclusionEfforts to close the gap in the quality of life of Indigenous children must prioritise strategies that prevent severe ear disease (runny ears and perforation), including improved healthcare access, reduced household crowding, and better education, and more employment opportunities.

Examining relationships between parent-reported factors and recurring ear symptoms among Aboriginal and Torres Strait Islander children.

Aboriginal and Torres Strait Islander child ear health is complex and multiple. We examined relationships between parent-reported sociodemographic, child health, health service access factors and ear symptoms among Aboriginal and Torres Strait Islander children aged 3 to 7 years. The Longitudinal Study of Indigenous Children is a large child cohort study with annual parent-reported data collection. Generalised linear mixed model analyses examined Wave 1 (1309 children 0-5 years; 2008) predictors of being free of parent-reported ear symptoms in both Waves 2 and 3. A total of 1030 (78.7%) had no reported ear symptoms in either Wave 2 or 3. In the fully adjusted model, children who had been hospitalised in the past year (aOR = 2.16; 95% CI 1.19-3.93) and those with no ear symptoms (aOR = 2.94; 95% CI, 1.59-5.46) at Wave 1 had higher odds of no ear symptoms in both the subsequent waves. There were also relationships between parent main source of income-government pension or allowance as well as parents who reported no history of their own ear symptoms and higher odds of no ear symptoms in Waves 2 and 3 after partial adjustment for sociodemographic factors. These findings suggest relationships between different sociodemographic and health factors and parent-reported ear symptoms among Aboriginal and Torres Strait Islander children that warrant further investigation. So what? Children with parent-reported ear symptoms during the early years need holistic support to prevent future ear symptoms that impact health, social and educational life trajectories.

Against the use of the Strengths and Difficulties Questionnaire for Aboriginal and Torres Strait Islander children aged 2-15 years.

The Strengths and Difficulties Questionnaire is a widely used screening tool for emotional and behavioural problems in children. Recent quantitative analyses have raised concerns regarding its structural validity in Aboriginal and Torres Strait Islander communities. This paper aims to extend upon existing findings by analysing the factor structure of both the parent- and teacher-reported Strengths and Difficulties Questionnaire in this population across a broader age range than in previous studies. Participants were the caregivers and teachers of 1624 Aboriginal and Torres Strait Islander children (820 male, 804 female) aged 2-15 years from Waves 2-11 of the Longitudinal Study of Indigenous Children. The majority of children were Aboriginal living in major cities and inner regional areas. Internal consistency was estimated with McDonald's Omega. Exploratory structural equation modelling was conducted to investigate the factor structure of the parent-reported and teacher-reported versions of the Strengths and Difficulties Questionnaire. Responses from teachers demonstrated higher internal consistency than responses from parents, which was unacceptably low across most age groups. The purported five-factor structure of the Strengths and Difficulties Questionnaire failed to be replicated across both parent- and teacher-reported questionnaires. The results of bifactor and hierarchical exploratory structural equation models also failed to approximate the higher-order summary scales. These results indicate that the Strengths and Difficulties Questionnaire subscales and summary scores do not provide a valid index of emotional and behavioural problems in Aboriginal and Torres Strait Islander children. The Strengths and Difficulties Questionnaire should not be used with Aboriginal and Torres Strait Islander children.

Parent Perspectives of Ear Health and the Relationship with Children's Speech and Language in the Longitudinal Study of Indigenous Children.

Health and well-being are holistic concepts that are perceived to be inseparable for Aboriginal and Torres Strait Islander peoples. We examined relationships between parent-reported ear symptoms for 787 Indigenous children at two time points (age 2-3 years, age 4-5 years) and two parent-reported speech and language outcomes one year later (age 5-6 years). Most parents (80.2%) reported no concern about their child's expressive language and (93.8%) receptive language. Binary logistic regression models examined ear health as a predictor of children's expressive and receptive speech and language adjusting for sociodemographic and health covariates. For children without parent-reported ear symptoms, there were lower odds of parental concern about expressive speech and language (aOR = 0.45; 95% CI 0.21-0.99) and receptive language (aOR = 0.24; 95% CI 0.09-0.62). Parents were less likely to have concerns about the child's expressive speech and language if their child was female, lived in urban or regional areas, had excellent or very good global health, or had no disability when aged 2-5 years. Since parent-reported ear health and speech and language concerns were related, Aboriginal and Torres Strait Islander children could benefit from culturally safe, strength-based, and family-centered integrated speech, language, and ear health services.

Remote housing for Indigenous children in the Fitzroy Valley, Western Australia: A case study

AbstractPoor‐quality and overcrowded housing in remote communities in Australia is widely seen to negatively impact Indigenous children's health and development. Despite widespread reports of, in some instances, quite appalling housing conditions, recent analyses of data from the Longitudinal Study of Indigenous Children (LSIC) found little evidence of adverse housing effects for Indigenous children living in very remote Australia. Given the apparent inconsistency in evidence coming from representative survey data and other accounts, a small‐scale case study was conducted in the Kimberley's Fitzroy Valley to gain greater insights into housing in very remote communities for families with school‐aged children. The LSIC very remote sample is confirmed to offer a good representation of housing conditions in these communities, based on replication of key housing data items in a small survey of Fitzroy Valley parents. While not apparent in those parent surveys, problems of severe overcrowding were highlighted in interviews with community leaders. Other issues raised included delays in maintenance and repairs and a lack of local input into housing management and associated employment, which was seen to disempower communities.

Parent wellbeing, family screen time and socioeconomic status during early childhood predict physical activity of Aboriginal and Torres Strait Islander children at ages 8-13.

Physical activity is holistically linked to culture and wellbeing among Aboriginal and Torres Strait Islander peoples, the First Nation Peoples of Australia. Socioecological correlates of high physical activity among Indigenous children include living in a remote area and low screen time but little is known about early life determinants of physical activity. This paper examines sociodemographic, family, community, cultural, parent social and emotional wellbeing determinants of physical activity among Aboriginal and Torres Strait Islander children. Longitudinal cohort study. The Longitudinal Study of Indigenous Children, the largest First Nations child cohort study in the world, primarily collects data through parental report. Multiple logistic regression analyses examined Wave 1 (age 0-5 years) predictors of achieving ≥1 h/day of physical activity at Wave 9 (aged 8-13 years). Of the 1181 children, 596 (50.5 %) achieved ≥1 h of physical activity every day. Achieving ≥1 h/day of physical activity at Wave 9 was associated with the following Wave 1 determinants: high parent social and emotional wellbeing (resilience; adjusted odds ratio 1.87 (95 % confidence interval: 1.32-2.65)), living in remote (odds ratio 3.66 (2.42-5.54)), regional (odds ratio 2.98 (2.13-4.18)) or low socioeconomic areas (odds ratio 1.85 (1.08-3.17)), main source of family income not wages/salaries (odds ratio 0.66 (0.46-0.97)), and if families played electronic games (odds ratio 0.72 (0.55-0.94)). To achieve high physical activity levels among Aboriginal and Torres Strait Islander children, high parental culture specific social and emotional wellbeing and low family screen time in early life may compensate for apparently low socio-economic circumstances, including living in remote areas.

Association between lack of dental service utilisation and caregiver-reported caries in Australian Indigenous children: A national survey.

To investigate the association between the lack of dental service utilisation and dental caries in Australian Indigenous children. Data from the Longitudinal Study of Indigenous Children, which is a longitudinal population-based cross-sectional study in Australia were analysed. A total of 1258 children were included, consisting of the baby cohort and the child cohort at Wave 7. Logistic regression analysis was conducted to examine the association between caregiver-reported child dental caries and dental service utilisation. Multiple imputation using the fully conditional specifications approach was used to account for missing data. Around one tenth (12.3%) of Indigenous children did not see a dentist when required. Lack of dental service utilisation was associated with an increased likelihood of caregiver-reported dental caries (odds ratio (OR) 2.4; 95% confidence interval (CI) 1.5-3.8) and teeth removed due to dental caries (OR 2.3; 95% CI 1.1-4.7). These associations remained after adjusting for confounders (caregiver-reported dental caries OR 2.3; 95% CI 1.3-3.8; teeth removed due to dental caries OR 2.1; 95% CI 1.0-4.4). The reasons reported for not utilising dental services when required were the lack of an available dentist (31.4%), difficulties with physical access (19.8%), long waiting times (13.9%), financial issues with cost (5.8%) and feeling that 'they could cope' (4.6%). Lack of dental service utilisation was associated with dental caries and extraction due to caries in Australian Indigenous children.

Protective Factors against Self-Harm and Suicidality among Australian Indigenous Adolescents: A Strengths-Based Analysis of the Longitudinal Study of Indigenous Children.

Background: Understanding and encouraging social and emotional well-being (SEWB) among Indigenous adolescents is vital in countering the impacts of colonisation and intergenerational trauma. As self-harm and suicidality are considered markers of poor SEWB among Indigenous communities, we aimed to identify the individual-level and community-level factors protecting Indigenous adolescents from self-harm and suicidality. Methods: Data came from Footprints in Time—The Longitudinal Study of Indigenous Children (waves 10 and 11), conducted among Indigenous families across Australia. A strengths-based analysis fitted multilevel logistic regression to explore associations with factors proposed as protective against self-reported self-harm and suicidality among Indigenous adolescents. Results: Our study cohort included 365 adolescents with complete data for the variables of interest. Adolescents had a mean (SD) age of 14.04 (0.45) years and a sex ratio of almost 1:1, and most were attending school (96.2%). Previous self-harm was reported by 8.2% (n = 30); previous suicidality was reported by 4.1% (n = 15). Individual-level factors protecting against self-harm and suicidality were being male, living in a cohesive family, and having low total Strengths and Difficulty Questionnaire scores (p < 0.05 for all). Residing in major cities compared with regional/remote areas was protective against self-harm (OR 5.94, 95% CI 1.31–26.81). Strong cultural identity was not found to be a protective factor against self-harm and/or suicidality in the sample. Conclusions: This study identified key individual- and community-level factors that can protect Australian Indigenous adolescents against self-harm and suicidality, particularly family cohesion. Identifying strengths for this at-risk population can inform prevention strategies, particularly for rural living adolescents with high distress.

Housing quality, remoteness and Indigenous children’s outcomes in Australia

In Australia, the Indigenous population disproportionately resides in more remote parts of the country, and a number of outcomes for Indigenous children decline with remoteness. It is widely accepted that inferior housing conditions, notably crowding, contribute to Indigenous disadvantage in remote communities, and this has become a focus of policy despite limited direct empirical evidence. Data from the Longitudinal Study of Indigenous Children are used to analyse children’s outcomes in the domains of physical health, social and behavioural adjustment, and educational achievement conditional upon remoteness and housing circumstances. For housing, variables relating to housing affordability stress, frequent moves, tenure and dwelling type and a range of measures of crowding are tested. The results suggest variation in housing conditions plays a relatively minor role in children’s physical health and social and emotional development. The most robust associations identified are between homeownership status and educational achievement. However, housing factors are not found to have significant mediating roles in the relationship between remoteness and children’s outcomes. The findings provide grounds for caution that a focus on housing should not distract policy efforts away from other potentially important determinants of the wellbeing of Indigenous children in remote Australia.

Exploratory Graph Analysis of the Strengths and Difficulties Questionnaire for Aboriginal and/or Torres Strait Islander Children.

In Australia, one of the most frequently used measures for assessing social and emotional well-being (SEWB) of Aboriginal and/or Torres Strait Islander children is the Strengths and Difficulties Questionnaire (SDQ). Previous studies on state-level validations have indicated the problems associated with the original five-factor SDQ structure, especially in the dimension of Peer Problems. The aim of this study was to use a novel psychometric methodology, namely Exploratory Graph Analysis (EGA), to evaluate the dimensionality of caregiver-informant SDQ version 4–10 years at a national level in Australia. Data for this study were retrospectively collected from two independent longitudinal studies: the Longitudinal Study of Indigenous Children (LSIC) and South Australian Aboriginal Birth Cohort (SAABC). The caregiver-informed SDQ version 4–10 years was applied across several study waves, including more than 4,000 responses. To conduct EGA, Gaussian graphical models (GGMs) were estimated using the Least Absolute Shrinkage and Selection Operator. About 2,500 bootstrap samples were also employed to investigate dimensions and item stability. The findings indicated robust evidence against the construct validity of the original five-factor SDQ structure. Future studies should conduct a direct external validation of the findings with Aboriginal and/or Torres Strait Islander parents/carers and community groups to develop the guidelines for future use of the instrument among Aboriginal and/or Torres Strait Islander children in Australia.

Footprints in Time: Physical Activity Levels and Sociodemographic and Movement-Related Associations Within the Longitudinal Study of Indigenous Children.

Emerging evidence suggests that Indigenous children have higher physical activity levels that non-Indigenous children, yet little is known of the factors that influence these levels or how they may be optimized. This study examines correlates of achieving ≥1hour/day of physical activity among Indigenous Australian children aged 8-13years. Data were collected through parental self-report in the Longitudinal Study of Indigenous Children. Proportions of children achieving ≥1hour/day physical activity, approximating the Australian aerobic physical activity recommendations, were calculated, and associations with sociodemographic, family composition, and movement-related factors were quantified using multiple logistic regression analyses. Half of the 1233 children achieved ≥1hour/day physical activity. Children from families with low parental education and unemployment, remote residence, low socioeconomic status, and without a father in the household were more likely to meet the recommendations. Achieving ≥1hour/day of physical activity was also associated with low levels of playing electronic games and total screen time. Sociodemographic correlates of physical activity among Indigenous Australian children run counter to those typically found in non-Indigenous Australian children. Further longitudinal examination of the predictors of these associations would provide a greater understanding of Indigenous physical activity determinants, to inform strategies to facilitate participation.

The consequences of household composition and household change for Indigenous health: evidence from eight waves of the Longitudinal Study of Indigenous Children (LSIC)

ABSTRACT Households are important health contexts, providing social, emotional, financial and material support, but little is known about the role of household composition in the social etiology of Indigenous health. Our research is framed by an Indigenous standpoint, using eight waves of data from the Longitudinal Study of Indigenous Children. We investigated whether household composition and change in household composition were associated with the self-reported general health of Indigenous children and their mothers, adjusting for socioeconomic, household structure and social support factors. Our measure of household composition comprised eight groups differentiating lone and couple parents, living with and without other children and adults. Study children in couple households with other children and adults were 16% less likely to have excellent health and mothers in these same households were 7% less likely to report excellent health than children and mothers in couple households. We find little evidence that mothers in lone parent households have poorer health than mothers in couple households, after adjustment for covariates. Change in household composition was positively associated with health for both children and mothers. The results caution against presuming a direct translatability of research findings from non-Indigenous to Indigenous Peoples.

Sport and academic performance in Australian Indigenous children

Objective Sport may promote academic performance through physiological and psychosocial mechanisms. We aimed to examine the association between sports participation and academic performance in Aboriginal and Torres Strait Islander children. Methods Participants were from four successive waves of Australia’s Longitudinal Study of Indigenous Children ( n = 303, baseline age 5–6 y). Cumulative sports participation was regressed against academic performance from two standardised tests. Results Children participating in sport at all four waves performed significantly better than children participating in sport in 0, 2 or 3 waves in Progressive Achievement Test (PAT) Maths (110 vs. 103, 105 and 105, p = 0.007, 0.02 and 0.02, respectively), and better than children participating at two waves in National Assessment Program – Literacy and Numeracy (NAPLAN) numeracy (438 vs. 409, p = 0.006). There were no significant differences in PAT reading or NAPLAN literacy. Conclusion Sports participation appears to be associated with subsequent better numeracy (2–7 months of learning) in a sample of Australian indigenous children. Fostering sports participation among indigenous children may be an avenue for reducing disadvantage.

Upholding heightened expectations of Indigenous children? Parents do, teachers do not

Abstract This paper argues that a component of increasing the rate of Aboriginal and Torres Strait Islander children and youths completing their secondary education is having parents and teachers maintain heightened expectations of these children in achieving this goal. To understand this phenomenon, we investigate the importance of, and discrepancies between, primary caregiver and teacher outlooks regarding Indigenous youths completing year 12. For the purpose of this paper, we adopt the term ‘primary caregiver’ in place of parent. This is because the majority (87.7%) of P1s analysed are the biological mothers with the remainder being close female relatives. P2s analysed are all male, 93.3% are biological fathers; remainder are step-fathers or adoptive fathers. This paper uses quantitative data from the Longitudinal Study of Indigenous Children to measure expectations from parents and teachers of Indigenous children. Results suggest that parents maintain exceptionally high expectations of their children, while teacher's expectations significantly decline over the course of Indigenous children's primary and secondary schooling years. We suggest that relationships and communication between parents and teachers, regarding expectations of students, are important to establishing an equilibrium in expectations of children, and that teachers may benefit from further training to address any underlying biases towards Indigenous children.

Strengths-based approaches for quantitative data analysis: A case study using the australian Longitudinal Study of Indigenous Children.

In Australia and internationally, there are increasing calls for the use of strengths-based methodologies, to counter the dominant deficit discourse that pervades research, policy, and media relating to Indigenous health and wellbeing. However, there is an absence of literature on the practical application of strengths-based approaches to quantitative research. This paper describes and empirically evaluates a set of strategies to support strengths-based quantitative analysis.A case study about Aboriginal and Torres Strait Islander child wellbeing was used to demonstrate approaches to support strengths-based quantitative analysis, in comparison to the dominant deficit approach of identifying risk factors associated with a negative outcome. Data from Wave 8 (2015) of the Australian Longitudinal Study of Indigenous Children were analysed. The Protective Factors Approach is intended to enable identification of factors protective against a negative outcome, and the Positive Outcome Approach is intended to enable identification of factors associated with a positive health outcome. We compared exposure-outcome associations (prevalence ratios and 95% confidence intervals (CIs), calculated using Poisson regression with robust variance) between the strengths-based and deficit approaches.In this case study, application of the strengths-based approaches retains the identification of statistically significant exposure-outcome associations seen with the standard deficit approach. Strengths-based approaches can enable a more positive story to be told, without altering statistical rigour. For Indigenous research, a strengths-based approach better reflects community values and principles, and it is more likely to support positive change than standard pathogenic models. Further research is required to explore the generalisability of these findings.