Torres Strait Research Articles

Empowering communities through data literacy: a qualitative study exploring Indigenous Australian perceptions, engagement and understanding of data

Data literacy is an essential competency needed to use data to inform decisions and participate in contemporary society. Importantly, in the context of Indigenous health it enables engagement with health services and facilitates health management, Indigenous data sovereignty and Indigenous data governance. However, while Indigenous data sovereignty and Indigenous data governance are gaining momentum globally, there are no mechanisms for understanding or enhancing data literacy within Indigenous communities. To explore this, a research project was co-designed between the QUT Centre for Data Science and the Aboriginal and Torres Strait Islander Community Health Service Brisbane (ATSICHS), a community-controlled health service in Queensland Australia, to provide insights into the current state of data literacy, community perceptions of data, and identify community suggestions for enhancing data literacy. Furthermore, by utilizing an Indigenist research design, the project ensured Aboriginal and Torres Strait Islander Peoples’ ways of knowing, being, and doing were privileged and prominent throughout research design, data collection and analysis. The qualitative study included 20 semi-structured interviews with Brisbane Aboriginal and/or Torres Strait Islander Peoples who had accessed or engaged with ATSICHS. This paper presents insights into Aboriginal and Torres Strait Islander Peoples’ perspectives on data and data literacy, which may benefit community-controlled organizations and other Indigenous communities within Australia and around the world.

Benchmarking for healthy food stores: protocol for a randomised controlled trial with remote Aboriginal and Torres Strait Islander communities in Australia to enhance adoption of health-enabling store policy and practice

BackgroundAboriginal and Torres Strait Islander communities in remote Australia have initiated bold policies for health-enabling stores. Benchmarking, a data-driven and facilitated ‘audit and feedback’ with action planning process, provides a potential strategy to strengthen and scale health-enabling best-practice adoption by remote community store directors/owners. We aim to co-design a benchmarking model with five partner organisations and test its effectiveness with Aboriginal and Torres Strait Islander community stores in remote Australia.MethodsStudy design is a pragmatic randomised controlled trial with consenting eligible stores (located in very remote Northern Territory (NT) of Australia, primary grocery store for an Aboriginal community, and serviced by a Nutrition Practitioner with a study partner organisation). The Benchmarking model is informed by research evidence, purpose-built best-practice audit and feedback tools, and co-designed with partner organisation and community representatives. The intervention comprises two full benchmarking cycles (one per year, 2022/23 and 2023/24) of assessment, feedback, action planning and action implementation. Assessment of stores includes i adoption status of 21 evidence-and industry-informed health-enabling policies for remote stores, ii implementation of health-enabling best-practice using a purpose-built Store Scout App, iii price of a standardised healthy diet using the Aboriginal and Torres Strait Islander Healthy Diets ASAP protocol; and, iv healthiness of food purchasing using sales data indicators. Partner organisations feedback reports and co-design action plans with stores. Control stores receive assessments and continue with usual retail practice. All stores provide weekly electronic sales data to assess the primary outcome, change in free sugars (g) to energy (MJ) from all food and drinks purchased, baseline (July-December 2021) vs July-December 2023.DiscussionWe hypothesise that the benchmarking intervention can improve the adoption of health-enabling store policy and practice and reduce sales of unhealthy foods and drinks in remote community stores of Australia. This innovative research with remote Aboriginal and Torres Strait Islander communities can inform effective implementation strategies for healthy food retail more broadly.Trial registrationACTRN12622000596707, Protocol version 1.

Primary health care utilisation and delivery in remote Australian clinics during the COVID-19 pandemic

IntroductionThe COVID-19 pandemic period (2020 to 2022) challenged and overstretched the capacity of primary health care services to deliver health care globally. The sector faced a highly uncertain and dynamic period that encompassed anticipation of a new, unknown, lethal and highly transmissible infection, the introduction of various travel restrictions, health workforce shortages, new government funding announcements and various policies to restrict the spread of the COVID-19 virus, then vaccination and treatments. This qualitative study aims to document and explore how the pandemic affected primary health care utilisation and delivery in remote and regional Aboriginal and Torres Strait Islander communities.MethodsSemi-structured interviews were conducted with staff working in 11 Aboriginal Community-Controlled Health Services (ACCHSs) in outer regional, remote and very remote Australia. Interviews were transcribed, inductively coded and thematically analysed.Results248 staff working in outer regional, remote and very remote primary health care clinics were interviewed between February 2020 and June 2021. Participants reported a decline in numbers of primary health care presentations in most communities during the initial COVID-19 lock down period. The reasons for the decline were attributed to community members apprehension to go to the clinics, change in work priorities of primary health care staff (e.g. more emphasis on preventing the virus entering the communities and stopping the spread) and limited outreach programs. Staff forecasted a future spike in acute presentations of various chronic diseases leading to increased medical retrieval requirements from remote communities to hospital. Information dissemination during the pre-vaccine roll-out stage was perceived to be well received by community members, while vaccine roll-out stage information was challenged by misinformation circulated through social media.ConclusionsThe ability of ACCHSs to be able to adapt service delivery in response to the changing COVID-19 strategies and policies are highlighted in this study. The study signifies the need to adequately fund ACCHSs with staff, resources, space and appropriate information to enable them to connect with their communities and continue their work especially in an era where the additional challenges created by pandemics are likely to become more frequent. While the PHC seeking behaviour of community members during the COVID-19 period were aligned to the trends observed across the world, some of the reasons underlying the trends were unique to outer regional, remote and very remote populations. Policy makers will need to give due consideration to the potential effects of newly developed policies on ACCHSs operating in remote and regional contexts that already battle under resourcing issues and high numbers of chronically ill populations.

Evaluating Student Equity Initiatives: A Student-Centred Approach

The robust evaluation of student equity initiatives is now an expected activity in Australian universities. This paper reports on the development of Swinburne’s Higher Education Participation and Partnerships Program (HEPPP) Evaluation Framework in which the project team adopted a student-centred design approach. The needs of Aboriginal and Torres Strait Islander students were positioned at the heart of the methodology and provided the starting point of explorations of student experiences in interviews and focus groups. We found that psychosocial support activities were critical to Indigenous students and those from low socioeconomic statue and/or regional or remote backgrounds and identified several additional Outcome factors of equity programs. Furthermore, we propose ‘Prosperity’ as a new Impact factor for evaluating equity programs to capture a broader notion of ‘success’. We argue that insights from existing institutional evaluation frameworks need to complement the Student Equity in Higher Education Evaluation Framework (SEHEEF) as Australia’s national framework and inform its continuous improvement.

The Jimmie Barker corpus: A Muruwari man’s documentation of Aboriginal languages, history and culture between 1968 and 1972

ABSTRACT Jimmie Barker (1900–1972) was a Muruwari Elder, Cultural Knowledge Holder, linguist, historian, ethnographer, inventor and sound engineer who produced over 113 h of audio recordings using reel-to-reel tape recorders between 1968 and 1972. Jimmie was supported in his endeavours by Janet Mathews and the Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS) (formerly, the Australian Institute of Aboriginal Studies). The “Barker Collection” of audio recordings is now housed in the AIATSIS Collection. Jimmie initially set out to record a Muruwari-English dictionary, but this expanded into documenting Muruwari language and culture, as well as personal, family, domestic and international history. Much of the collection comprises self-elicitation, metalinguistic analyses, oral histories and reflections. It includes some of the earliest recordings and language documentation by an Aboriginal person of other Aboriginal people, observations of typological properties and language change in Aboriginal languages, and critical analyses of linguistic and anthropological research. Since 2021, Roy J. Barker, grandson of Jimmie and Muruwari Cultural Knowledge Holder, has overseen a team of linguists designing a time-aligned ELAN corpus of Jimmie’s recordings for language revival outcomes. The recordings are transcribed, annotated with metadata and coded with cultural and language tags with consideration to the FAIR and CARE Principles.

Taking Stock of Indigenous-State Treaty-Making in Australia: Opportunities and Challenges

Aspirations for an Indigenous treaty or treaties in Australia must confront a challenging landscape. How can we retrofit a substantive treaty-making process on a legal and political system that has not been designed to engage meaningfully with Aboriginal and Torres Strait Islander peoples? Talking treaty more than two hundred years after first contact is difficult, but many jurisdictions are exploring this conundrum right now. This article provides an update on the Indigenous-State treaty processes underway in Australia. It then examines five key issues that these processes are currently grappling with.

Administration of Burns First Aid Treatment to Aboriginal and Torres Strait Islander children in community settings

ObjectiveThis paper investigates Burn First Aid Treatment (BFAT) provided to Aboriginal and Torres Strait Islander children in Australia at the scene of injury using data from a population-based cohort study. Study DesignThe participants were 208 Aboriginal and Torres Strait Islander children aged < 16 years who sustained a burns injury between 2015–2018, and their carers. The primary outcome measure was gold standard BFAT, (defined as at least 20 min of cool, running water within 3 h of the injury); additional measures included type of first aid, length of first aid provided, and carer's knowledge of first aid. ResultsOf the 208 caregivers, 168 provided open-ended responses that indicated first aid was applied to their child; however, only 34 received gold standard BFAT at the scene of the injury, 110 did not receive correct BFAT, and 24 were unsure what first aid was applied. ConclusionThis study highlights an important need for communities to have access to appropriate evidence-based and co-designed BFAT education and training.

Generating evidence to inform responsive and effective actions for Aboriginal and Torres Strait Islander adolescent health and well-being: a mix method protocol for evidence integration ‘the Roadmap Project’

BackgroundAustralia does not have a national strategy for Aboriginal and Torres Strait Islander adolescent health and as a result, policy and programming actions are fragmented and may not be responsive...

Kidney transplantation access and outcomes for Aboriginal and Torres Strait Islander children and young adults, 1963-2020: an ANZDATA registry study.

To assess differences between Aboriginal and Torres Strait Islander and non-Indigenous Australian children and young adults in access to and outcomes of kidney transplantation. A cohort study based on prospectively collected data; analysis of Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) data. Children and young adults aged 0-24 years who commenced kidney replacement therapy in Australia during 1963-2020. Proportions of children and young adults who received kidney transplants within five years of commencing dialysis; 5- and 10-year death-censored graft survival; and 5- and 10-year survival of children and young adults who received kidney transplants or who remained on dialysis. During 1963-2020, 3736 children and young adults received kidney replacement therapy in Australia: 213 (5.8%) Aboriginal and Torres Strait Islander and 3523 (94.2%) non-Indigenous children and young adults. During follow-up (median, eight years; interquartile range [IQR], 2.6-15 years), 2762 children and young adults received kidney transplants: 93 Aboriginal and Torres Strait Islander (43.7% of those receiving kidney replacement therapy) and 2669 non-Indigenous children and young adults (75.8%). Smaller proportions of Aboriginal and Torres Strait Islander than of non-Indigenous children and young adults received transplants within five years of commencing dialysis (99, 46% v 2924, 83.0%), received living donor transplants (19, 20% v 1170, 43.9%), or underwent pre-emptive transplantation (one, 1.1% v 363, 13.6%). Five-year graft survival for Aboriginal and Torres Strait Islander recipients was similar to non-Indigenous recipients (61% v 75%; adjusted hazard ratio [aHR], 1.43; 95% confidence interval [CI], 0.02-2.05), but 10-year graft survival was lower (35% v 61%; aHR, 1.69; 95% CI, 1.25-2.28). Five- and 10-year survival after kidney transplantation was similar for Aboriginal and Torres Strait Islander and non-Indigenous people. Among those who remained on dialysis, 10-year survival was poorer for Aboriginal and Torres Strait Islander than non-Indigenous children and young adults (aHR, 1.50; 95% CI, 1.08-2.10). Five-year graft and recipient survival were excellent for Aboriginal and Torres Strait Islander children and young adults who received kidney transplants; however, a lower proportion received transplants within five years of dialysis initiation, than non-Indigenous children and young adults. Improving transplant access within five years of dialysis commencement should be a priority.

Aged care service use by Aboriginal and Torres Strait Islander people after aged care eligibility assessments, 2017-2019: a population-based retrospective cohort study.

To characterise the socio-demographic characteristics, aged and health care needs, and aged care services used by older Aboriginal and Torres Strait Islander people assessed for aged care service eligibility. Population-based retrospective cohort study; analysis of Registry of Senior Australians (ROSA) National Historical Cohort data. Aboriginal and Torres Strait Islander people aged 50 years or older who were first assessed for aged care service eligibility (permanent residential aged care, home care package, respite care, or transition care) during 1 January 2017 - 31December 2019. Socio-demographic and aged care assessment characteristics; health conditions and functional limitations recorded at the time of the assessment; subsequent aged care service use. The median age of the 6209 people assessed for aged care service eligibility was 67 years (interquartile range [IQR], 60-75 years), 3626 were women (58.4%), and 4043 lived in regional to very remote areas of Australia (65.1%). Aboriginal health workers were involved in 655 eligibility assessments (10.5%). The median number of health conditions was six (IQR, 4-8); 6013 (96.9%) had two or more health conditions, and 2592 (41.8%) had seven or more. Comorbidity was most frequent among people with mental health conditions: 597 of 1136 people with anxiety (52.5%) and 1170 of 2416 people with depression (48.5%) had seven or more other medical conditions. Geriatric syndromes were recorded for 2265 people (36.5%); assistance with at least one functional activity was required by 6190 people (99.7%). A total of 6114 people (98.5%) were approved for at least one aged care service, 3218 of whom (52.6%) subsequently used these services; the first services used were most frequently home care packages (1660 people, 51.6%). Despite the high care needs of older Aboriginal and Torres Strait Islander people, only 52% used aged care services for which they were eligible. It is likely that the health and aged care needs of older Aboriginal and Torres Strait Islander people are not being adequately met.

Sexual risk and testing for sexually transmissible infections in Aboriginal and Torres Strait Islander peoples and non-Indigenous young South Australians: results of an online survey.

Background Disproportionate rates of sexually transmissible infections (STIs) among Aboriginal and Torres Strait Islander young people are often attributed to risk-taking behaviours, but research rarely conducts direct comparison with their non-Indigenous peers to address this negative discourse. Methods 'Let's Talk About It 2019' was a cross-sectional online survey of South Australians (16-29 years). It prioritised recruitment of Aboriginal and Torres Strait Islander respondents to compare behaviours with non-Indigenous peers using multivariable Poisson regression models. Results Aboriginal and Torres Strait Islander (n =231) and non-Indigenous (n =2062) respondents reported similar condom use (40% vs 43%, P =0.477) and sexual debut median ages (16 years vs 17 years). Higher proportions of Aboriginal and/or Torres Strait Islander respondents reported a recent health check (48% vs 38%, P =0.002), STIs (60% vs 49%, P P =0.006) testing, STI diagnosis (29% vs 21%, P =0.042), and intoxication during last sex (30% vs 18%, P Conclusions Behaviours associated with STI transmission were mostly similar among Aboriginal and Torres Strait Islander and non-Indigenous respondents. Higher STI/HIV testing among Aboriginal and Torres Strait Islander respondents suggests effectiveness of targeted programs. Interventions targeting substance use and condom use among all young people are needed. Future interventions need to focus beyond behaviours and explore social determinants of health and sexual networks as contributors to disproportionate STI rates.

The emergence of cultural safety within kidney care for Indigenous Peoples in Australia.

Cultural safety is increasingly recognised as imperative to delivering accessible and acceptable healthcare for First Nations Peoples within Australia and in similar colonised countries. A literature review undertaken to inform the inaugural Caring for Australians with Renal Insufficiency (CARI) guidelines for clinically and culturally safe kidney care for Aboriginal and Torres Strait Islander peoples revealed a timeline of the emergence of culturally safe kidney care in Australia. Thirty years ago, kidney care literature was purely biomedically focused, with culture, family and community viewed as potential barriers to patient 'compliance' with treatment. The importance of culturally informed care was increasingly recognised in the mid-1990s, with cultural safety within kidney care specifically cited from 2014 onwards. The emergence timeline is discussed in this paper in relation to the five principles of cultural safety developed by Māori nurse Irihapeti Ramsden in Aotearoa/New Zealand. These principles are critical reflection, communication, minimising power differences, decolonisation and ensuring one does not demean or disempower. For the kidney care workforce, culturally safe care requires ongoing critical reflection, deep active listening skills, decolonising approaches and the eradication of institutional racism. Cultural safety is the key to truly working in partnership, increasing Indigenous Governance, respectful collaboration and redesigning kidney care.

Towards precision cancer medicine for Aboriginal and Torres Strait Islander cancer health equity.

Delivering cancer control at scale for Aboriginal and Torres Strait Islander communities is a national priority that requires Aboriginal and Torres Strait Islander leadership and codesign, as well as significant involvement of the Aboriginal community-controlled health sector. The unique genomic variation observed among Aboriginal and Torres Strait Islander peoples may have implications for standard and precision medicine. Yet, Aboriginal and Torres Strait Islander peoples are absent from, or under-represented within, human reference genome resources, genomic studies, cancer studies, cancer cell lines, patient-derived xenografts and cancer clinical trials. Genomics-guided precision cancer medicine offers an opportunity to reduce cancer health disparities experienced by Aboriginal and Torres Strait Islander peoples through personalising prevention, diagnosis, treatment and long term management. Here, we describe what is required to ensure that Aboriginal and Torres Strait Islander peoples can receive the benefits of precision cancer medicine. Equity of access to care, an Aboriginal and Torres Strait Islander cancer workforce, and appropriate genome reference resources are important for safe and effective cancer medicine. Building Indigenous data sovereignty principles and Aboriginal and Torres Strait Islander governance into research is required to protect Aboriginal and Torres Strait Islander rights and collective interests. Aboriginal and Torres Strait Islander community engagement should be undertaken to develop an understanding of the unique cultural and ethical considerations for precision cancer research. Local and national genomic health research guidelines are needed to define a consensus best practice in genomics research with Aboriginal and Torres Strait Islander peoples.

Healing the Past by Nurturing the Future: trauma-aware, healing-informed care to improve support for Aboriginal and Torres Strait Islander families – implementation and evaluation study protocol

IntroductionComplex trauma can have serious impacts on the health and well-being of Aboriginal and Torres Strait Islander families. The perinatal period represents a ‘critical window’ for recovery and transforming cycles...

Self-reported hearing loss in urban Aboriginal and Torres Strait Islander adults: unmeasured, unknown and unmanaged.

Background Effective management of hearing loss in adults is fundamental for communication, relationships, employment, and learning. This study examined the rates and management of self-reported hearing loss in urban Aboriginal and Torres Strait Islander adults. Methods A retrospective, observational study of Aboriginal and Torres Strait Islander people aged ≥15years who had annual health checks at an urban Aboriginal and Torres Strait Islander primary healthcare clinic in Inala, Queensland, was conducted to determine self-reported hearing loss rates by age and ethnic groups stratified by sex. A medical record audit of patients who self-reported hearing loss from January to June 2021 was performed to identify current management approaches, and the proportion of patients that were appropriately managed. Results Of the 1735 patients (average age 40.7years, range 15.0-88.5years, 900 [52.0%] women) who completed 3090 health checks between July 2018 and September 2021, 18.8% self-reported hearing loss. Rates did not differ between men and women. However, significant effects were noted for age, with rates increasing from 10.7% for patients aged 15-24years to 38.7% for those aged ≥65years. An audit of 73 patient medical records revealed that 39.7% of patients with self-reported hearing loss were referred to Ear, Nose and Throat/audiology or received other management. A total of 17.8% of patients owned hearing aids. Conclusions Only 40% of Aboriginal and Torres Strait Islander adults who self-reported hearing loss were referred for management. Significant changes to clinical management and government-funded referral options for hearing services are required to improve the management of self-reported hearing loss in this population.

Evaluation of the Cultural, Social and Emotional Wellbeing Program with Aboriginal women in the Boronia Pre-Release Centre for Women: a mixed methods study.

To assess the effectiveness of the Cultural, Social and Emotional Wellbeing Program for reducing psychological distress and enhancing the social and emotional wellbeing of Aboriginal women preparing for release from prison. Mixed methods; qualitative study (adapted reflexive thematic analysis of stories of most significant change) and assessment of psychological distress. Aboriginal and Torres Strait Islander women at the Boronia Pre-release Centre for Women, Perth, Western Australia, May and July 2021. Cultural, Social and Emotional Wellbeing Program (two days per week for six weeks). The Program involves presentations, workshops, activities, group discussions, and self-reflections designed to enhance social and emotional wellbeing. Themes and subthemes identified from reflexive thematic analysis of participants' stories of most significant change; change in mean psychological distress, as assessed with the 5-item Kessler Scale (K-5) before and after the Program. Fourteen of 16 invited women completed the Program; ten participated in its evaluation. They reported improved social and emotional wellbeing, reflected as enhanced connections to culture, family, and community. Mean psychological distress was lower after the Program (mean K-5 score, 11.3; 95% confidence interval [CI], 9.0-13.6) than before the Program (9.0; 95% CI, 6.5-11.5; P=0.047). The women who participated in the Program reported personal growth, including acceptance of self and acceptance and pride in culture, reflecting enhanced social and emotional wellbeing through connections to culture and kinship. Our preliminary findings suggest that the Program could improve the resilience of Aboriginal and Torres Strait Islander in contact with the justice system.

The Double Folds of Racism and History

Abstract Aboriginal and Torres Strait Islander men have been overrepresented proportionately in specific sports—boxing, rugby league, and Australian rules football—that have been associated with concussion, but there is little written material, research, scholarship, commentary, or understanding about how they have been affected by traumatic brain injuries related to their participation. This article addresses this silence by examining two overlapping folds of history. The first fold explores the general silences about sport concussion that existed until recently. The second fold is centered on the traumatic consequences of colonization on the health and well-being of Australia's First Nations peoples. While the first silence is being addressed in a multitude of complex ways, the second silence remains a disturbing feature of contemporary sport. We argue that for the recognition, diagnoses, and treatment of concussion and brain injuries in Aboriginal and Torres Strait Islander peoples, there needs to be an appreciation of the continuing consequences of colonization and significant changes in the Western health system.

Multiculturalism, Islamophobia and the Muslim Minority in Australia: A Reflection

Australia’s approach to multiculturalism has been a journey of evolving policies and societal shifts. The country’s immigration policies in the 1960s marked a significant departure from the restrictive ‘White Australia’ policy, leading to a more diverse cultural, ethnic, and religious population. Recognizing the potential for value and norm conflicts, the Australian government adopted multiculturalism as a state ideology, aiming to foster social cohesion and reduce inter-community conflicts. This policy has been largely successful in managing conflicts, as evidenced by the relatively low incidence of political, ethnic, and religious violence, including terrorism, compared to other nations. The positive impact of multiculturalism is evident in the thriving Australian Muslim communities, which, along with other ethnic and religious groups, have been able to preserve their cultural heritage. These communities contribute significantly to the social and economic fabric of the nation. However, despite the overarching success of multiculturalism, challenges persist. The Muslim minority in Australia has faced Islamophobia, manifesting in both overt attacks and subtle forms of discrimination. This has been a complex issue, with some Muslim groups maintaining a degree of exclusivity and engaging in identity politics, while also recognizing and embracing the broader multicultural ethos that has become an integral part of Australia’s identity. The Australian government has continued to refine its multicultural policies, with initiatives aimed at promoting anti-racism, access, and equity since 2010. These efforts are part of a broader commitment to diversity, belonging, and inclusion, which encompasses Aboriginal and Torres Strait Islander peoples as well. The policy landscape is complemented by state and territory policies that further support multiculturalism. Despite the progress, the experiences of Australian Muslims highlight the ongoing need for vigilance against discrimination. Reports indicate that Australian Muslims are a diverse group, facing stereotypes and prejudice that can perpetuate social tensions. The Australian Human Rights Commission has emphasized the importance of sharing the stories of Australian Muslims to foster understanding and address Islamophobia. The Commission’s findings underscore the need for a national anti-racism framework and strong leadership to combat discrimination and support social cohesion. While Australia’s multicultural policy has been a beacon of successful integration and social harmony, it is clear that the journey is not complete. The nation continues to grapple with the dual realities of a celebrated multicultural society and the undercurrents of intolerance that challenge it. The experiences of the Australian Muslim community serve as a reminder of the work that remains to be done in ensuring that multiculturalism is not just a state ideology but a lived reality for all Australians. The path forward lies in education, awareness, and institutional change that upholds the values of diversity and inclusion for every individual in the nation.

A Delphi study and development of a social and emotional wellbeing screening tool for Australian First Nations Peoples living in the Torres Strait and Northern Peninsula Area of Australia

A Delphi study and development of a social and emotional wellbeing screening tool for Australian First Nations Peoples living in the Torres Strait and Northern Peninsula Area of Australia

A Brief Online Motivational Tool to Promote Early Help-Seeking in Men Using Abuse and Violence in Relationships: A Feasibility Trial.

Men's use of domestic violence is a major public health issue globally. However, the potential for technology to address this issue has been limited within research and practice. This study aimed to test the feasibility and acceptability of an online healthy relationship tool (BETTER MAN) for men who have used domestic violence to encourage help-seeking. A pre- and postsurvey with a 3-month follow-up was used. One hundred and forty men enrolled, with retention rates of 79% (111) immediately after BETTER MAN and 62% (86) at 3 months. Participants were diverse men (mean age of 32 years, 33% born outside Australia, 19% in same-sex relationships, and 2% Aboriginal or Torres Strait Islander). The majority (70%, 58) of men reported behaviors classified as moderate risk (e.g., checked partner's phone, picked on partner, and controlled money) and 24% (20) as high-risk behaviors (e.g., scared partner, physical force, and unwanted sexual activities). Post BETTER MAN, there was a significant increase in mean intention to contact counseling service (baseline 5.8, immediately 6.7, and 3-month follow-up 7.2) and mean confidence in the ability to seek help (baseline 3.7, immediately 5.1, and 3-month follow-up 7.2). Men's readiness to make changes in behavior median score significantly moved from baseline (5.9-I am not ready to take action), immediately (6.7-I am ready to make some changes), and 3-month follow-up (7.2-I have begun to change my behavior). At 3-month follow-up, 55% (47/86) of men reported accessing counseling services compared with 34% (46/140) of men at baseline. Findings suggest that it is feasible that BETTER MAN might work to engage men to seek help and is acceptable to men using domestic violence. However, a large-scale randomized controlled trial is needed to determine the effectiveness of BETTER MAN on help-seeking behaviors for men's use of domestic violence.