Torres Strait Islander People Research Articles

Writing across a cultural interface: a guide for non-Indigenous writers

ABSTRACT In recent years non-Indigenous writers have grappled with inclusion and representation of Aboriginal Australian and Torres Strait Islander peoples in creative works. Historically, and at times in contemporary fiction, writers have misrepresented, marginalised, or omitted Indigenous people as characters. Writers who craft regional and rural settings perhaps bear a greater onus than their metropolitan peers to characterise Indigenous people due to an expectation of a greater extent of unbroken Indigenous connections to ‘Country’ beyond the dense infrastructure of cityscapes. With the rise of First Nations authorship and authority, non-Indigenous writers are often advised to either avoid writing Indigenous characters or to get to know traditional owners and refine their writing skills to achieve authenticity. In this article, I offer my experience as a non-Indigenous writer crafting a farm novel that situates Aboriginal characters at the centre of the farm and the narrative. My writing process required constant awareness of a cultural interface and an approach that I hoped would recognise yet not impinge on Indigenous knowledge, beliefs, and authorship. My experience led to the development of a set of guidelines that may be useful to other writers crafting Australian settings.

Older Aboriginal and Torres Strait Islander People's Experiences With Hearing Loss and Audiological Services: A Scoping Review.

In Australia, older Aboriginal and Torres Strait Islander people have the highest prevalence of hearing loss, for which dedicated audiological services are available. However, there is limited research on the experiences older Aboriginal and Torres Strait Islander people have with hearing loss and audiological services. Therefore, this study aimed to consolidate existing literature with a scoping review, specifically on the above to identify gaps and guide future research. Ten databases, including electronic journal databases and government databases, were systematically searched. Additional studies were sought from article reference lists, review articles, conference abstracts and Google Scholar. We identified 540 records and 22 of them met our inclusion criteria. Our inclusion criteria constituted research of any design on the experiences of older Aboriginal and Torres Strait Islander people (aged 45+ years) with hearing loss and audiological services. Seventeen studies reported on experiences with hearing loss, four studies reported on experiences with audiological services and one study reported on both experiences. Prevalence of hearing loss was estimated to be 20%-34% in older Aboriginal and Torres Strait Islander people; a discrepancy between self-reported and objective hearing difficulties was also identified. Audiological services currently available to older Aboriginal and Torres Strait Islander people were also underutilised. Future research on older Aboriginal and Torres Strait Islander people is required to uncover: (1) the reasons for underreported hearing loss; (2) types of hearing loss experienced; (3) barriers to accessing audiological services; and (4) best hearing-loss management and rehabilitation practices.

Yarning for a purpose: Listening to how First Nations People define safety and wellbeing

AbstractDefining safety and wellbeing measurements for Aboriginal and Torres Strait Islander children and young people can be difficult due to its subjectivity. This article discusses findings from yarning circles held with Aboriginal and Torres Strait Islander peoples discussing these very definitions. It is argued through the findings; Aboriginal and Torres Strait Islander knowledge must be incorporated when defining safety and wellbeing measures such as connection to culture, family and housing.

“I have a sis in the profession for life, that’s who my mentor is”: evaluating a pilot mentoring programme for Aboriginal and Torres Strait Islander speech pathology students and professionals

Aboriginal and Torres Strait Islander peoples face significant challenges in accessing mainstream health services due to the ongoing impacts of racism, colonisation, and intergenerational trauma. To address health inequalities, it is important to build Aboriginal and Torres Strait Islander workforce capacity in the health professions where there is significant under-representation. A pilot mentoring programme was developed to support Aboriginal and Torres Strait Islander ear and hearing health professionals and students, which aimed to understand their expectations and experiences. Six participants enrolled in the study, two mentors and four mentees, all from a speech pathology background. The study found that maintaining relationships with other Aboriginal speech pathologists was vital for longevity in the profession. The study stresses the importance of workplaces and universities ensuring that individuals are not thrown into culturally unsafe situations and that they are culturally safe and responsive.

Interventions for Aboriginal and Torres Strait Islander people with type 2 diabetes that modify its management and cardiometabolic risk factors: asystematic review.

To review studies of interventions for reducing the impact of type 2 diabetes in Aboriginal and Torres Strait Islander people. The primary aim was to review and summarise the characteristics and findings of the interventions. The secondary aims were to assess their effects on diabetes and cardiometabolic risk factors, and the proportions of people with type 2 diabetes who achieved therapeutic targets with each intervention. We searched eight electronic databases for publications of studies including Aboriginal or Torres Strait Islander people aged 15 years or older with diagnoses of type 2 diabetes, describing one or more diabetes interventions, and published in English during 1 January 2000 - 31 December 2020. Reference lists in the assessed articles were checked for further relevant publications. MEDLINE (Ovid), Web of Science (Clarivate), the Cochrane Library, Global Health (EBSCO), Indigenous Collection and Indigenous Australia (Informit), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the World Health Organization International Clinical Trials Registry Platform (WHO-ICTRP). The database searches yielded 1424 unique records; after screening by title and abstract, the full text of 55 potentially relevant articles were screened, of which seventeen met our eligibility criteria: eleven cohort studies (seven retrospective audits and four prospective studies), three randomised controlled trials, and three observational, non-randomised follow-up studies. Twelve publications reported site-based (Aboriginal or Torres Strait Islander health service or diabetes clinic) rather than individual-based diabetes interventions. Interventions with statistically significant effects on mean glycated haemoglobin (HbA1c) levels were laparoscopic adjustable gastric banding, a 5-day diabetes self-management camp, treatment of Strongyloides stercoralis infections, community-based health worker-led management, point-of-care testing, and self-management approaches. Few interventions for Aboriginal and Torres Strait Islander people with type 2 diabetes have been reported in peer-reviewed publications. Improving diabetes care services resulted in larger proportions of people achieving therapeutic HbA1c targets. Outcomes were better when Aboriginal and Torres Strait Islander communities were involved at all levels of an intervention. High quality studies of holistic, culturally safe and accessible interventions should be the focus of research.

Responsive service design and workforce strengthening: Recommendations to improve aged care for Aboriginal and Torres Strait Islander peoples.

This study aimed to develop innovative and practical strategies and recommendations for aged care policy and practice that support the needs of Aboriginal and Torres Strait Islander peoples. A research symposium was held in June 2023 on Kaurna Country at the South Australian Health and Medical Research Institute. The symposium brought together 70 attendees including aged care consumers, Federal and State Government representatives, advocacy services, health, aged care and social service providers, and health and aged care researchers. Two roundtable sessions titled 'Responsive Service Design' and 'Workforce Strengthening' were conducted following a World Café approach. Data were analysed thematically. This paper proposes recommendations relating to innovation and improvement within aged care policy and practice. Recommendations for responsive service design and workforce strengthening include the following: (1) promote genuine engagement and involvement, (2) establish partnerships between sectors, (3) ensure compliance, (4) innovative communication and feedback pathways, (5) holistic approaches to well-being, (6) prioritise cultural safety and (7) flexible recruitment and retention strategies. Working together and building partnerships between diverse stakeholders including community members, workforce, service providers and policymakers is required for sustainable and meaningful innovation within the aged care sector. Our recommendations, driven by community needs, provide an opportunity to ensure the innovation and implementation of ongoing aged care reforms meet the needs and expectations of Aboriginal and Torres Strait Islander peoples.

Racial discrimination and Aboriginal and Torres Strait Islander suicide mortality rates in Queensland.

The study aimed to examine the associations between experiences of racial discrimination within communities with suicide mortality rates for Aboriginal and Torres Strait Islander people. Age-standardised suicide rates (ASRs) were calculated using suicides recorded by the Queensland Suicide Register (QSR) of Aboriginal and Torres Strait Islander people in Queensland from 2009 to 2015. Rate Ratios (RRs) were used to compare ASRs in areas with high and low levels of reported discrimination, and other comparative community-level risk and protective factors (remoteness, socio-economic resources, and Indigenous language use). The age-standardised suicide rate was 31.74 deaths per 100 000 persons/year for Aboriginal and Torres Strait Islander people for the years 2009-2015. ASRs were significantly higher in areas where more of the First Nations residents experienced recent discrimination (RR = 1.33; 95%CI = 1.05-1.70, p = 0.02), and the age-specific suicide rate was significantly higher for those aged 25-34 in areas with more discrimination (RR = 1.67; 95%CI = 1.04-2.74, p = 0.03). By comparison, the ASRs were not significantly higher in areas with regional and remote communities (RR = 1.10, CI 95%=0.75-1.61, p = 0.60), or areas with lower socioeconomic resources (RR = 0.86, 95%CI = 0.66-1.13, p = 0.28). Areas in which more First Nations residents spoke Indigenous languages had significantly lower ASRs (RR = 0.71; CI95%=0.53-0.95, p = 0.02). Suicide mortality rates for Aboriginal and Torres Strait Islander people in Queensland were influenced by experiences of racial discrimination within communities and Indigenous language use, with greater associations reported than with socio-economic resources or remoteness. The findings reflect the public health risk of discrimination and provide evidence for enacting strategies to reduce institutional and personal discrimination to reduce suicide.

The revised remote area nurse model of consultation.

The aim of this revision was to update the Remote Area Nurse (RAN) Model of Consultation (MoC) and was prompted by publication of the National Rural and Remote Nursing Generalist Framework (2013-2018), shifts in RAN workforce patterns, community health patterns and technology use. Rural and remote residents face higher rates of hospitalisations, deaths and poorer access to health care with a significant burden of avoidable fatal conditions among Aboriginal and Torres Strait Islander peoples. Health care is mostly provided by RANs and Aboriginal and Torres Strait Islander Health Practitioners (ATSIHPs), addressing diverse health needs, a mobile population and navigating cross-cultural situations. Despite challenges such as clinician shortages, RANs manage a significant portion of non-emergency consultations. The RAN MoC was developed to ensure comprehensive, systematic and person-centred care and to mitigate risk to the client, the nurse and the health service. The 11 expert panel members, all authors, revised the RAN MoC through a series of Microsoft Teams meetings, one face-to-face meeting and an exchange of emails. The principles were reorganised under the four domains of the National Rural and Remote Nursing Generalist Framework and mapped against the National Safety and Quality Primary and Community Health Care Standards. The revised RAN MoC is designed to provide evidence based culturally informed care, standardise RAN consultation best practice and improve the health outcomes of their clients. With the increased turnover and number of nurses 'new' to remote, more innovative approaches to education and dissemination of the model is necessary.

Indigenous Australian Perspectives on the Perinatal Period: Social Well-Being, Culture and Early Infant Attachments

ObjectiveAlthough social factors and culture are significant determinants of health in Aboriginal and Torres Strait Islander peoples, little is known academically about key interpersonal and social experiences of this population during the perinatal period, or how early attachments are formed through culture. This study addressed this gap in the literature. Methods and MeasuresA reflexive thematic analysis approach was applied to the data gathered from focus groups (N = 14) held with Aboriginal (N = 7) and Torres Strait Islander (N = 7) mothers and their kinship systems. ResultsFive prominent interpersonal and social themes were identified: maternal-fetal attachment, infant-kinship attachment, caretaking roles/shared caregiving, traditional adoption, and ceremonies and rites of passage. Characteristics of maternal-fetal attachment were aligned with the construct in non-Indigenous literature. Post-utero, caretaking/shared caregiving roles such as ‘big mum/dad’ and ‘small mum/dad’ were identified. Ceremonies and rites of passage were understood to cement cultural roles within the kinship system, and the role of the maternal uncle was highlighted. A cultural obligation to help raise the child for biological mothers’ other siblings, known as ‘mums’ and ‘dads’, was identified. ConclusionDiscussion is centred around the necessity for ‘grass roots’ research from the perspectives of Aboriginal and Torres Strait Islanders, and on suggestions for future research in further exploring the themes derived from this research.

Which Way? Experiences of Aboriginal and Torres Strait Islander People Who Are Deaf or Hard of Hearing Attaining Supports to Meet Their Interwoven Socio-Cultural, Health and Disability-Related Needs and Aspirations Within the Context of Australia’s National Disability Insurance Scheme

Which Way? Experiences of Aboriginal and Torres Strait Islander People Who Are Deaf or Hard of Hearing Attaining Supports to Meet Their Interwoven Socio-Cultural, Health and Disability-Related Needs and Aspirations Within the Context of Australia’s National Disability Insurance Scheme

Physical activity interventions to prevent and manage type 2 diabetes in Aboriginal and Torres Strait Islander people: a systematic review.

To review evidence regarding the impact of physical activity interventions for preventing and managing type 2 diabetes in Aboriginal and Torres Strait Islander Australians. We searched for published reports of physical activity interventions for preventing and managing type 2 diabetes in Indigenous adults (18 years or older). There were no exclusion criteria regarding study type or duration, frequency, length, or intensity of physical activity, except that short term interventions were excluded. We assessed the quality of each study using the Joanna Briggs Institute (JBI) critical appraisal tools and the ethical and methodological quality of studies from an Indigenous Australian perspective with the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE) Critical Appraisal Tool. MEDLINE; Scopus, Embase (Elsevier); Cumulative Index to Nursing and Allied Health Literature (CINAHL), Sports Discus, PsycINFO (EBSCO); Informit Complete; ProQuest Dissertations and Theses, and ProQuest Health and Medicine; each from their inception to 30 October 2022. The database searches identified 703 potentially relevant records; after removing duplicates and initial screening, the full text of 27 articles was assessed for eligibility. Nine studies met our inclusion criteria: two randomised controlled trials, five cohort studies, one quasi-experimental study, and one repeated cross-sectional study. Eight studies were rated as being of low or medium quality (median JBI score, 54%; interquartile range [IQR], 36-64%); seven studies were rated as being of low to medium ethical and methodological quality from the Indigenous perspective (median CREATE score, 50%; IQR, 36-64%). Six studies reported changes in glycated haemoglobin (HbA1c) levels, of which two (both cohort studies) reported significantly lower mean HbA1c levels after the intervention, but only one publication provided detailed results. No randomised controlled trials that investigated the effect of a combination of physical activity and dietary change for Indigenous Australians diagnosed with type 2 diabetes were identified. Differences in study design, outcome variables, and the small number of studies precluded meta-analysis. Quality research into the impact of physical activity interventions on type 2 diabetes in Indigenous people is sparse. To improve research translation, studies that involve Indigenous community members at all levels of the research process are needed. PROSPERO CRD42021247496 (prospective).

"It's Everybody's and It's Nobody's Responsibility": Stakeholder Perspectives on Aboriginal and Torres Strait Islander Health Equity at the Nexus of Chronic Kidney Disease and Oral Health.

The effects of racism, oppression, and colonization in Australia are reflected in the inequitable experience of chronic kidney disease (CKD) among Aboriginal and Torres Strait Islander peoples. Despite having the highest incidence of CKD, Aboriginal and Torres Strait Islander people have the lowest rate of kidney transplant, with poor oral health commonly being an obstacle to receiving a transplant. This research reflects the exploratory phase of a larger project aimed at maximizing oral health outcomes for Aboriginal and Torres Strait Islander people living with CKD in Australia through the provision of culturally secure dental care. The present research uses reflexive thematic analysis to analyze qualitative data from yarns, interviews, and focus groups with dental, renal, and Aboriginal and Torres Strait Islander stakeholders to generate a conceptual understanding of equity at the nexus of oral health and kidney health. NVivo software was used for organizing data and an inductive line-by-line coding approach. Twenty-eight stakeholders participated; 12 of the stakeholders identified as Aboriginal and/or Torres Strait Islander, and most were female. Factors at the nexus of oral health and CKD included the continuous effects of colonization, the centrality of cultural security for improved care, as well as several challenges and opportunities at a system level. Challenges included the luxury of oral health access, limited health care team involvement in oral health pathways, high-intensity engagement with medical systems, and no communication between dental and renal teams. Opportunities identified included the role of integrated care, cross-discipline knowledge sharing, Aboriginal and Torres Strait Islander leadership, clear referral pathways, prevention, and assistance with navigating the oral health system. We argue that collective responsibility for the oral health of Aboriginal and Torres Strait Islander people living with CKD is required for improved health and eligibility for kidney transplant. Cross-discipline collaboration is required to overcome the rigidness of the current colonial and biomedical model that silos oral health and CKD. The siloed approach to management of oral health for Aboriginal and Torres Strait Islander peoples with chronic kidney disease results in low knowledge sharing and communication across chronic disease management teams and can prevent kidney transplantation. Collective responsibility for oral health within this context is required to ensure that just and equitable access to kidney transplant can be achieved.

Sepsis associated acute kidney injury is common among Aboriginal and Torres Strait Islanders with septic shock and has poor outcomes: A nested cohort study.

Exploration of the incidence and outcomes of Acute Kidney Injury (AKI) broadly, and sepsis associated AKI specifically, in Aboriginal and Torres Strait Islander (First Nations) people has been limited. We compared a nested cohort of First Nations people drawn from a multinational randomised controlled trial of hydrocortisone in septic shock, to a cohort matched for age, sex and severity of illness. Acute Kidney Injury was defined using the Kidney Disease Improving Global Outcomes (KDIGO) criteria, as well as incident use of kidney replacement therapy (KRT). Major Adverse Kidney Events (MAKE) were described as the composite of death, new dialysis requirement or persisting kidney dysfunction at hospital discharge. A cohort of 57 Aboriginal and/or Torres Strait Islander patients with septic shock was identified. 91.2% (52) of the First Nations cohort met KDIGO criteria for Stage 1 AKI or greater and 63% (36) met Stage 3 criteria. 59.6% (34) of the First Nations required dialysis as compared to 45.6% (26) in the matched cohort. 60.7% (34) of First Nations participants met criteria for MAKE at hospital discharge. The proportions requiring dialysis at 6, 12 and 24 months were 8.3%, 9.1% and 6.9% respectively. The incidences of AKI and MAKE reported in this First Nations cohort are substantially higher than in previously published cohorts of patients with sepsis, even those that use sensitive definitions of AKI. Measures to promote better management of infectious diseases in First Nations communities are required.

Criminalising Coercive Control in New South Wales: Misunderstandings and Missed Opportunities

In 2022, New South Wales (‘NSW’) became the first Australian jurisdiction to criminalise coercive control, with the offence commencing on 1 July 2024. This follows the creation of similar offences overseas. These novel offences are designed to respond to the extensive critique of the criminal law which has largely focused on discrete incidents of physical violence leaving absent the full range and pattern of abuse experienced as domestic and family violence. In legislating in this area, the NSW Government sought to balance key tensions that emerged in the debates about criminalisation, such as: not to over-reach; the risk of victims being misidentified as offenders; the over-criminalisation of Aboriginal and Torres Strait Islander peoples; while at the same time addressing coercive control. In this article, I critically examine the NSW offence drawing attention to various misunderstandings about coercive control and misidentification that appear to underpin the NSW approach.

Historical and Contemporary Burden of ESKD among Torres Strait Islander People of Australia, 1963-2022

Historical and Contemporary Burden of ESKD among Torres Strait Islander People of Australia, 1963-2022

“It’s [gambling] obviously not regulated that well”: insights into Aboriginal peoples’ views on gambling regulation in the Northern Territory of Australia

Abstract Aim This study is the first in-depth qualitative study that has provided insights into Aboriginal (All participants in this study identified as Aboriginal and thus we have not included any reference to the Torres Strait Islander peoples in this paper.) people’s views on current gambling policy and legislation in the Northern Territory (NT), Australia. Subject and methods In-depth semi-structured qualitative interviews were conducted with a targeted selection of participants. The sample comprised 29 participants, aged 18+ years, weekly and nonregular gamblers, and those negatively affected by others’ gambling. An open coding technique (a combination of inductive and deductive analyses) was used for data analysis. Appropriate ethics approval was also obtained. Results Participants described gambling as a revenue-generating product for the government and the gambling industry. Hence, their role in influencing the regulation of gambling for public benefit was debated. Participants provided practical suggestions that the government and the gambling industry could adopt to inform gambling regulation to minimise harm from gambling among Aboriginal people and the wider community in the NT. The suggestions included establishing stricter regulations relating to the licensing and opening hours of venues, limiting bet size and restricting the availability of gaming machines at venues. Participants also encouraged the reinstatement of mandatory formal dress codes at venues and the creation of health promotion resources such as advertisements and awareness campaigns tailored to the needs of the local Aboriginal people. Conclusion Both community-wide and targeted approaches are required to regulate and reduce gambling harm among Aboriginal people in the NT. Although both are important, having more explicit preventive approaches in place may eliminate the need for downstream interventions and strategies.

Relationships between social determinants of health and healthy body composition among Aboriginal and Torres Strait Islander youth in the Next Generation: Youth Well-being study.

Little is currently known about the relationships between body composition and the social determinants of health among Aboriginal and Torres Strait Islander youth in Australia, which could help inform policy responses to address health inequities. This study aimed to explore the relationship between various social factors and healthy body mass index (BMI) and waist/height ratio (WHtR) among Aboriginal and Torres Strait Islander youth aged 16-24 years. Baseline survey data from 531 participants of the 'Next Generation: Youth Well-being study' were used. Robust Poisson regression quantified associations between healthy body composition and self-reported individual social factors (education, employment and income, government income support, food insecurity, home environment, relationship status, racism), family factors (caregiver education and employment) and area-level factors (remoteness, socioeconomic status). Healthy body composition was less common among those living in a crowded home (healthy WHtR aPR 0.67 [0.47-0.96]) and those receiving government income support (healthy BMI aPR 0.74 [0.57-0.95]). It was more common among those with tertiary educated caregivers (healthy BMI aPR 1.84 [1.30-2.61]; healthy WHtR aPR 1.41 [1.05-1.91]) and those in a serious relationship (healthy BMI aPR 1.33 [1.02-1.75]). Social factors at the individual and family level are associated with healthy body composition among Aboriginal and Torres Strait Islander youth. SO WHAT?: The findings of this study highlight the potential for health benefits for youth from policies and programs that address social inequities experienced by Aboriginal and Torres Strait Islander people in Australia.

How universities can support Aboriginal and Torres Strait Islander peoples to achieve self-determination and improved wellbeing.

The right to self-determination is enshrined in international law, affirming Aboriginal people have the right to make decisions about matters that affect their lives, including meeting their social, political, cultural and economic needs. This paper explores the role of universities in supporting Aboriginal self-determination, including an examination of the importance of the social and cultural determinants of wellbeing and the impacts of assimilation on Aboriginal people’s ability to live in accord with cultural traditions. Insights into how universities can create more culturally appropriate learning environments are also reviewed with a particular focus on the fundamental differences between Western and Aboriginal culture, pedagogy, epistemology, ontology, and axiology. The paper suggests that by undertaking a process of truth telling, universities will be able to create improved learning and research environments for Aboriginal students and staff that better support self-determination. By doing this, universities will leverage their unique position of influence to create improved wellbeing for Aboriginal people and the nation as a whole. This is an invited article based on a HERDSA keynote address, which was presented at the 2024 conference held in Adelaide, 8-11 July. Dr Callaghan was also invited to provide a video introduction to the article. The video link may be found on the ASRHE journal site next to the link to the PDF.

Supporting alcohol brief interventions and pharmacotherapy provision in Australian First Nations primary care: exploratory analysis of a cluster randomised trial

IntroductionPrimary care provides an important opportunity to detect unhealthy alcohol use and offer assistance but many barriers to this exist. In an Australian context, Aboriginal Community Controlled Health Services (ACCHS) are community-led and run health services, which provide holistic primary care to Aboriginal and Torres Strait Islander peoples. A recent cluster randomised trial conducted with ACCHS provided a service support model which showed a small but significant difference in provision of ‘any treatment’ for unhealthy alcohol use. However, it was not clear which treatment modalities were increased.AimsTo test the effect of an ACCHS support model for alcohol on: (i) delivery of verbal alcohol intervention (alcohol advice or counselling); (ii) prescription of relapse prevention pharmacotherapies.MethodsIntervention: 24-month, multi-faceted service support model. Design: cluster randomised trial; equal allocation to early-support (‘treatment’) and waitlist control arms. Participants: 22 ACCHS. Analysis: Multilevel logistic regression to compare odds of a client receiving treatment in any two-month period as routinely recorded on practice software.ResultsSupport was associated with a significant increase in the odds of verbal alcohol intervention being recorded (OR = 7.60, [95% CI = 5.54, 10.42], p < 0.001) from a low baseline. The odds of pharmacotherapies being prescribed (OR = 1.61, [95% CI = 0.92, 2.80], p = 0.1) did not increase significantly. There was high heterogeneity in service outcomes.ConclusionsWhile a statistically significant increase in verbal alcohol intervention rates was achieved, this was not clinically significant because of the low baseline. Our data likely underestimates rates of treatment provision due to barriers documenting verbal interventions in practice software, and because different software may be used by drug and alcohol teams. The support made little impact on pharmacotherapy prescription. Changes at multiple organisational levels, including within clinical guidelines for primary care, may be needed to meaningfully improve provision of alcohol treatment in ACCHS.Trial registrationACTRN12618001892202 (retrospectively registered on 21/11/2018).

Food intake in an Australian Aboriginal rural community facing food and water security challenges: A cross-sectional survey.

Researchers were invited by Aboriginal leaders to collaborate on this study which aimed to assess food intake in the Walgett Aboriginal community to inform long-term community-led efforts to improve food and water security and nutrition. Aboriginal adults living in or near Walgett, a remote community in north-west NSW, Australia, completed an adapted Menzies Remote Short-item Dietary Assessment Tool, which was administered verbally and face-to-face in early 2022. Aboriginal people were involved in the survey design, training and collection, and analysis of data. Descriptive statistics were tabulated, overall and by gender, age, and location. Differences by sex, age group (18-44 years versus ≥45 years), and location (Walgett town or other) were determined using a chi-square test. A total of 242 participants completed the survey; 55% were female. Three-quarters of participants reported meeting the recommendations for discretionary foods (73%); however, more than half (56%) exceeded the recommended maximum serves of sugar-sweetened beverages. The proportion of participants meeting core food group guidelines was 72% for meat, 36% for fruit, 20% for bread and cereals, 6% for dairy, and 3% for vegetables. Overall, none of the participants met the recommended serves of all food groups outlined in the Australian Dietary Guidelines. Findings show that Walgett Aboriginal community members surveyed were consuming a healthier diet than national data reported for Aboriginal and Torres Strait Islander people in Australia. However, none of the participants were meeting all of the national dietary guidelines, placing them at increased risk of diet-related chronic disease. Local Aboriginal community-led efforts to improve food and water security should include specific strategies to improve nutrition.