Urban Aboriginal Women Research Articles

Yarning about oral health: perceptions of urban Australian Aboriginal and Torres Strait Islander women

BackgroundMany factors influence how a person experiences oral health and how such experiences may facilitate supportive oral health behaviours. Women in particular face different challenges due to their environment, responsibilities and physiological differences to men. Within Australia, Aboriginal and Torres Strait Islander women are reported to have poorer oral health and are faced with additional barriers to supporting their oral health compared with non-Indigenous women. The objective of this paper is to report the experiences and perceptions of oral health from the perspective of urban, Aboriginal and Torres Strait Islander women.MethodsThe present data derive from a descriptive study that used yarning circles and face-to-face interviews with women who were mothers/carers of urban, Aboriginal and/or Torres Strait Islander children. This was a qualitative study to investigate the impact of child oral health on families. Participants used the opportunity to share their own personal experiences of oral health as women, thus providing data for the present analyses. Information collected was transcribed and analysed thematically.ResultsTwenty women shared their personal narratives on the topic of oral health which were reflective of different time points in their life: growing up, as an adult and as a mother/carer. Although women are trying to support their oral health across their life-course, they face a number of barriers, including a lack of information and the costs of accessing dental care. The teenage years and pregnancy were reported as important time periods for oral health support.ConclusionsTo improve the oral health of Indigenous Australian women, policymakers must consider the barriers reported by women and critically review current oral health information and services. Current oral health services are financially out of reach for Indigenous Australian women and there is not sufficient or appropriate, oral information across the life-course.

Mental Health Among Help-Seeking Urban Women: The Relationships Between Adverse Childhood Experiences, Sexual Abuse, and Suicidality.

Adverse childhood experiences (ACEs) and adult mental health were explored in a sample of urban Aboriginal ( n = 83) and non-Aboriginal ( n = 89) women. Childhood sexual abuse (CSA) was associated with negative home environments, teenage pregnancy, lifetime suicide attempts, and treatment seeking. Aboriginal women with CSA witnessed higher levels of physical/sexual abuse of family members. The severity of current psychological distress was associated with a history of childhood neglect. The results indicate that CSA rarely occurs in isolation, and that multiple ACEs are strongly associated with suicide attempts and treatment seeking in adulthood. Future studies should focus on the role of CSA in suicidality, as well as familial, community, and cultural protective factors.

Conception of a resource: development of a physical activity and healthy living resource with and for pregnant urban First Nations and Métis women in Ottawa, Canada

First Nations and Métis women in Canada experience increased risk of poor health outcomes in pregnancy compared to non-Aboriginal women. There is limited literature on the availability and use of physical activity (PA) and obesity prevention resources for Aboriginal women during pregnancy, which are important components of prenatal health care. This paper aims to demonstrate how community-based participatory research (CBPR) led to the development of a resource for urban Aboriginal women to support them in being physically active and preventing excessive weight gain during pregnancy. Participants, who included pregnant or postpartum women and care providers who serve Aboriginal women during pregnancy, indicated a lack of access to relevant pregnancy resources. Participants suggested the development of a culturally safe online pregnancy application created for/with urban Aboriginal women in Ottawa. We contend that CBPR is an effective approach to health promotion and technology development that can lead to community-generated, culturally safe, relevant, and creative health interventions.

Bundap Marram Durn Durn: Engagement with Aboriginal women experiencing comorbid chronic physical and mental health conditions

Objective:To explore antecedents of health service engagement and experience among urban AboriginalaaIn this paper, Aboriginal people encompass all Aboriginal and/or Torres Strait Islander people – Australia's First People. people with comorbid physical and mental health conditions. Methods:Focus groups and interviews were conducted with Aboriginal people who had comorbid health conditions and were accessing Aboriginal and/or mainstream services.bbMainstream services are services operating outside of the Aboriginal community‐controlled health sector and include hospitals, primary health care, community health and a broad range of specialist services. Results:Nineteen participants, all women, were recruited. Participants' personal histories and prior experience of health services affected effective service utilisation. Participants’ service experiences were characterised by long waiting times in the public health system and high healthcare staff turnover. Trusted professionals were able to act as brokers to other clinically and culturally competent practitioners. Conclusions:Many urban Aboriginal women attended health services with multiple comorbid conditions including chronic disease and mental health issues. Several barriers and enablers were identified concerning the capacity of services to engage and effectively manage Aboriginal patients’ conditions. Implications:Results indicate the need to explore strategies to improve health care utilisation by urban Aboriginal women.

A postcolonial feminist discourse analysis of urban Aboriginal women's description of pregnancy-related weight gain and physical activity.

Excessive weight gain and physical inactivity in pregnancy have been identified as risk factors for negative health outcomes for mothers and fetuses, particularly among Aboriginal women. In this paper we engage with postcolonial feminist theory and critical discourse analysis to examine the question, "how do urban Aboriginal women understand pregnancy-related weight gain and physical activity." We conducted focus groups and semi-structured interviews with 25 urban Aboriginal pregnant or postpartum women between the ages of 16 and 39 in Ottawa, Canada. Three prominent discourses emerged: Aboriginal women have different pregnancies than non-Aboriginal women because Aboriginal women gain more weight and are more likely to develop gestational diabetes; Aboriginal women feel personally responsible for and shameful about excessive weight gain; finally, Aboriginal women need culturally safe pregnancy resources. Our results illuminate the complex and often paradoxical ways in which discourses around weight gain and physical activity are produced and taken-up by Aboriginal women and their healthcare providers. Based on these findings, we argue there is a lack of accessible and culturally safe resources for urban Aboriginal women, specifically concerning weight gain and physical activity in pregnancy. We recommend the development of resources that are created for/by/with Aboriginal women to better address that issues that urban Aboriginal women themselves identify as being of key importance.

‘I want to come here to prove them wrong’: using a post-colonial feminist participatory action research (PFPAR) approach to studying sport, gender and development programmes for urban Indigenous young women

How do young urban Aboriginal women in Vancouver, British Columbia, understand their experiences of participating in a sport, gender and development (SGD) programme that aims to enhance their lives? In this paper, we consider this question through a post-colonial feminist participatory action research (PFPAR) study designed to examine the contradictions and challenges surrounding SGD programmes that target urban Aboriginal young women. To do this, we draw on empirical work that involved interviews and photovoice activities conducted with 11 Aboriginal young women who participated in the Vancouver Aboriginal Friendship Centre Society's (VAFCS') recreation programme. Our findings demonstrate how stereotyping, encountering racism and gender inequalities in day-to-day life – and in the programme – created challenging circumstances for these young women. Despite these obstacles, the young women used the programme as an opportunity to resist and challenge perceptions about their bodies, sporting abilities, lifestyles and Aboriginal stereotypes.

Social Justice and Health Equity: Urban Aboriginal Women’s Action for Health Reform

Social Justice and Health Equity: Urban Aboriginal Women’s Action for Health Reform

Health and well‐being of urban Aboriginal and Torres Strait Islander women at their first antenatal visit: A cross‐sectional study

The first antenatal visit is a valuable opportunity to influence the health and well-being of the mother and child during pregnancy, birth and beyond. Our primary-care-based cross-sectional study of urban Aboriginal and Torres Strait Islander women found that 81% presented for their first antenatal visit within the first 10 weeks. Consequently, there can be up to 30 weeks in which health professionals can provide lifestyle and parenting education and psychosocial support.

Indigenous Methodologies: Traversing Indigenous and Western worldviews in research

Using Indigenous methodologies to guide a doctoral study honouring cultural traditions and protocols was integral in working with the local community. Traditional talking circles were used to create a culturally safe environment for urban Aboriginal women to talk about their health care experiences and recommend strategies for change. The methodological research process was guided and shaped by Elders and community members sharing their knowledge and stories. This fluid non-linearity and unpredictability, common in Indigenous methodologies, challenged the researcher to stay true to the methodology while simultaneously respecting cultural protocols and traditions. The successes and challenges of embracing Indigenous methodologies in the midst of academia without losing sight of respect, commitment and accountability to Indigenous peoples and the institution are offered.

“We eat more than kangaroo tail or dugong you know…”: Recent Indigenous Australian Cookbooks

This paper focuses on a series of cookbooks published by Indigenous Australian groups. These cookbooks are typically produced with government funding, and are developed by nutritionists, dieticians, and health workers in consultation with local communities. They are designed to teach Indigenous Australians to cook healthy, nutritious, low-cost meals. In this paper, Fredericks and Anderson identify the value of these cookbooks as low-cost, public health interventions. However, they note that their value as health interventions has not been tested. Fredericks and Anderson question the value of these cookbooks within the broader context of the health disadvantage faced by Indigenous Australians. They argue that the cookbooks are developed from a Western perspective of health and nutrition that fails to recognise the value of traditional Indigenous foodways. They suggest that incorporating more Indigenous food knowledge and food-related traditions into cookbooks may be one way of improving health among Indigenous peoples and revitalising Indigenous knowledge.

Silencing of Voice: An Act of Structural Violence Urban Aboriginal Women Speak Out About Their Experiences with Health Care

This article reports some of the preliminary findings of an ongoing participatory research study exploring the provision of health and social services for urban Aboriginal communities in the Okanagan Valley. In particular, the article examines how colonial structures and systems have worked to silence Aboriginal women’s voices and how this has affected the ways in which urban Aboriginal women seek out health services. The article addresses these issues through the voices of the Aboriginal women in the study. The women’s stories reveal the many assumptions and inequities that contribute to their marginalization. They describe how their voices are often silenced when they access health services and how this can cause them to either delay seeking needed health advice or accept the status quo. The women’s stories are used to stress the importance and power of voice. This is most evident in their experiences accessing the health services offered through community-based Friendship Centres, where many felt they had more control over the care they received. In the context of this article, the impacts of colonization and the silencing of women’s voices are viewed as acts of structural violence. The women’s stories provide crucial insights into how health care provision can be changed to help prevent these acts of violence, thus leading the way to improved health for all urban Aboriginal populations.

Shared decision-making and health for First Nations, Métis and Inuit women: a study protocol.

BackgroundLittle is known about shared decision-making (SDM) with Métis, First Nations and Inuit women (“Aboriginal women”). SDM is a collaborative process that engages health care professional(s) and the client in making health decisions and is fundamental for informed consent and patient-centred care. The objective of this study is to explore Aboriginal women’s health and social decision-making needs and to engage Aboriginal women in culturally adapting an SDM approach.MethodsUsing participatory research principles and guided by a postcolonial theoretical lens, the proposed mixed methods research will involve three phases. Phase I is an international systematic review of the effectiveness of interventions for Aboriginal peoples’ health decision-making. Developed following dialogue with key stakeholders, proposed methods are guided by the Cochrane handbook and include a comprehensive search, screening by two independent researchers, and synthesis of findings. Phases II and III will be conducted in collaboration with Minwaashin Lodge and engage an urban Aboriginal community of women in an interpretive descriptive qualitative study. In Phase II, 10 to 13 Aboriginal women will be interviewed to explore their health/social decision-making experiences. The interview guide is based on the Ottawa Decision Support Framework and previous decisional needs assessments, and as appropriate may be adapted to findings from the systematic review. Digitally-recorded interviews will be transcribed verbatim and analyzed inductively to identify participant decision-making approaches and needs when making health/social decisions. In Phase III, there will be cultural adaptation of an SDM facilitation tool, the Ottawa Personal Decision Guide, by two focus groups consisting of five to seven Aboriginal women. The culturally adapted guide will undergo usability testing through individual interviews with five to six women who are about to make a health/social decision. Focus groups and individual interviews will be digitally-recorded, transcribed verbatim, and analyzed inductively to identify the adaptation required and usability of the adapted decision guide.DiscussionFindings from this research will produce a culturally sensitive intervention to facilitate SDM within a population of urban Aboriginal women, which can subsequently be evaluated to determine impacts on narrowing health/social decision-making inequities.

Young urban Aboriginal women entrepreneurs: social capital, complex transitions and community support

The employment pattern of young people is particularly significant for the economic, social and cultural vitality of urban Aboriginal communities. This study of young women entrepreneurs focuses upon the role of social capital in transitions to self-employment. It considers how social capital operates through networks within and between groups, has effects which are positive and negative in youth transitions, assists personal development and contributes to the community. The complex transitions of young women into self-employment occur at the same time as educational careers and family responsibilities are developing. Support for young Aboriginal people seeking self-employment is provided through a number of government-supported programmes. Focus group discussions, with young women whose businesses are predominantly in creative and cultural industries, reveal the role of social networks within Aboriginal and non-Aboriginal communities in their development and demonstrate their commitment to giving somethi...

Gazing Boldly Back and Forward: Urban Aboriginal Women Artists and New Global Feminisms in Transnational Art

Gazing Boldly Back and Forward: Urban Aboriginal Women Artists and New Global Feminisms in Transnational Art

Mortality of urban Aboriginal adults in Canada, 1991–2001

To compare mortality patterns for urban Aboriginal adults with those of urban non-Aboriginal adults. Using the 1991-2001 Canadian census mortality follow-up study, our study tracked mortality to December 31, 2001, among a 15% sample of adults, including 16 300 Aboriginal and 2 062 700 non-Aboriginal persons residing in urban areas on June 4, 1991. The Aboriginal population was defined by ethnic origin (ancestry), Registered Indian status and/or membership in an Indian band or First Nation, since the 1991 census did not collect information on Aboriginal identity. Compared to urban non-Aboriginal men and women, remaining life expectancy at age 25 years was 4.7 years and 6.5 years shorter for urban Aboriginal men and women, respectively. Mortality rate ratios for urban Aboriginal men and women were particularly elevated for alcohol-related deaths, motor vehicle accidents and infectious diseases, including HIV/AIDS. For most causes of death, urban Aboriginal adults had higher mortality rates compared to other urban residents. Socio-economic status played an important role in explaining these disparities. Results from this study help fill a data gap on mortality information of urban Aboriginal people of Canada.

Family food work: lessons learned from urban Aboriginal women about nutrition promotion

This article reports on ethnographic study of urban Aboriginal family food and implications for nutrition promotion. Data were collected over 2 years through in-depth interviews and participant observation in groups conducted through Indigenous organisations in a suburb of Brisbane. Issues when organising family food include affordability, keeping family members satisfied and being able to share food, a lack of cooking ideas, the accessibility of nutrition information, additional work involved in ensuring healthy eating, and a desire for convenience. Many different health professionals provide nutrition advice, often directing it towards individuals and not providing adequate guidance to facilitate implementation. The easiest advice to implement worked from existing household food practices, skills and budget. Cooking workshops helped to provide opportunities to experiment with recommended foods so that women could confidently introduce them at home. Aboriginal women are concerned about healthy eating for their families. Disadvantage can limit dietary change and the complexity of family food work is often underestimated in nutrition promotion. Household, rather than individual, framing of nutrition promotion can lead to more sustainable healthy eating changes.

Yaitya Tirka Madlanna Warratinna : Exploring What Sexual Health Nurses Need to Know and Do in Order to Meet the Sexual Health Needs of Young Aboriginal Women in Adelaide

Young Aboriginal women are consistently identified as having poorer health outcomes and access to sexual health services than non-Indigenous Australians. Yet the literature is particularly silent on what sexual health nurses need to know and do in order to work well with young urban Aboriginal women. This paper reports on a qualitative pilot study undertaken by a non-Indigenous nurse in Adelaide. The participatory action research methods used in this study were sensitive to the history of problems associated with research in Aboriginal communities. A reference group of Elder Aboriginal women and Aboriginal health workers guided all aspects of the study. A partnership approach between the researcher and the Reference Group ensured that the methods, analysis, and final report were culturally safe. Three groups participated in this study: Elders and Aboriginal health workers; young Aboriginal women, and sexual health nurses. All participants acknowledged the importance of nurses being clinically competent. However, the overarching finding was a lack of a clear model of cultural care to guide health service delivery. Three interrelated themes emerged from the data to support this contention. These were: the structural and personal importance of establishing and maintaining trustworthy relationships between nurses, Aboriginal health workers and Elders; the recognition that Aboriginal culture does exist, and is important in urban areas; and the importance of gender considerations to understanding urban women's health business. A partnership approach was recommended as a way to use these findings to develop a transparent cultural model of care. Further research is currently being undertaken to progress this agenda.

Is it Aboriginal friendly? Searching for ways of working in research and practice that support Aboriginal women

This article describes my journey as a nurse as I search for better ways to work with urban Aboriginal women. Learning as I build and maintain trusting relationships with Elders, Aboriginal health professionals and communities has been an important first step. Incorporating reflective practice, participatory action research and ethical guidelines has further assisted me to work in more culturally safe and respectful ways. While there has been increasing recognition of access and equity issues in Australia’s current neo-colonial period, actual improvements have been very slow to emerge. Meanwhile many Aboriginal people continue to experience poor levels of health. My hope is that this article can contribute to the growing body of knowledge that recognises the impact of past and present colonisation practices and shifts health care towards collaborative healing and well being models that are more supportive of Aboriginal people and their needs. The emphasis on Aboriginal women’s health rather than mixed gender health care comes from my experiences in sexual health, where many Australian Aboriginal women prefer to access ‘women only’ services.

Prevalence of sexually transmitted infections in pregnant urban Aboriginal and Torres Strait Islander women in northern Australia

To assess the prevalence of sexually transmitted infections (STI) in a cohort of pregnant urban Indigenous women and association of STI with preterm birth, low birthweight birth and perinatal mortality. Prospective intervention program in a cohort of women attending Townsville Aboriginal and Islander Health Services (TAIHS) for shared antenatal care between 1 January 2000 and 31 December 2003 incorporating routine screening for chlamydia, gonorrhoea, trichomoniasis, hepatitis B and syphilis. Townsville is a provincial urban centre with a regional Indigenous population of over 16 000. Four hundred and fifty-six pregnant women who were screened for bacterial STI and other viral infections. Prevalence of STI, associated risk factors and perinatal outcomes. Of the 456 women, 403 (88.4%) were screened for chlamydia, gonorrhoea and trichomonas and 432 (94.7%) were screened for syphilis. A total of 92 cases of STI (20.2%, 95% CI 16.5-23.9) were detected, with 21 concurrent infection(s). The overall prevalence of chlamydia was 14.4%, gonorrhoea 6.1%, trichomoniasis 7.2% and infectious syphilis 2.5%. Predictors for STI were young age, harmful/hazardous alcohol use and unwanted pregnancy. Low birthweight and perinatal death were significantly associated with the presence of STI and infectious syphilis during pregnancy. The prevalence of STI among pregnant women in this urban Indigenous community is high, suggesting that screening for STI should be included in all antenatal care protocols for Indigenous women in Australia. Strategies to reach the whole Indigenous community of child-bearing age, especially those aged less than 25 years, are needed to improve perinatal outcome.

Body-Related Emotional Experiences of Young Aboriginal Women

Concerns related to the body are associated with health-compromising behaviors, and although research has indicated that young Aboriginal women are dissatisfied with their bodies, their voices have typically been absent from the literature. The purpose of this case study was to provide insight into the body-related emotional experiences of young, Canadian, urban Aboriginal women. Four young women participated; 3 identified themselves as Aboriginal (one 14-year-old, two 18-year-olds) and 1 as non-Aboriginal (18 years old). Multiple methods (focus group, one-on-one interviews, and artwork) provided the authors the opportunity to listen to the young women's stories. Five themes emerged: (a) conflicting cultures, (b) need to belong, (c) the beauty of difference, (d) journey to acceptance of the body, and (e) the body affects everything. This research highlights the complexity of young Aboriginal women's body-related emotional experiences and indicates that their experiences might not be as negative as previous research has led us to believe.