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First Nation, Indigenous and Aboriginal Perspectives of Health Promotion and Wellbeing

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Guest Editor
School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia
Interests: First Nation research; participatory action research; mental health and wellbeing; decolonising research; systems change

Special Issue Information

Dear Colleagues,

Just under half a billion First Nation, Indigenous and Aboriginal people live globally, making up just over six percent of the global population. Globalisation and colonisation have impacted greatly on the health and wellbeing of First Nation, Indigenous and Aboriginal populations. Consequently, First Nation, Indigenous and Aboriginal people make up almost twenty percent of people living in poverty globally [1]. With deep spiritual and familial connection to Land and Country, First Nation, Indigenous and Aboriginal people rely on the protective factors of culture to maintain physical health and social and emotional wellbeing. In Australia health promotion from a First Nation worldview perspective takes into account country, language, culture, kinship and self-determination to support living healthy lives [2]. Health promotion efforts cover a range of health aspects including healthy lifestyles, immunization, sexual health, mental health, healthy eating, environmental health, injury/accident prevention, men’s and women’s health, and parenting and birthing.

Effective communication, co-design approaches, decolonising research methodologies, Indigenous research frameworks, and Community-led participatory action research strategies feature prominently in First Nation, Indigenous and Aboriginal health promotion efforts to increase control over their health and its determinants, and thereby improve and protect their health [3].

Scholarly papers addressing these topics are invited to this special issue, particularly those with a practical focus where solutions are led by First Nation, Indigenous and Aboriginal communities.

References

[1] International Labour Organization. 2019. Implementing the ILO Indigenous and Tribal Peoples Convention No. 169: Towards an inclusive, sustainable and just future. Available online: https://www.ilo.org/wcmsp5/groups/public/---dgreports/---dcomm/---publ/documents/publication/wcms_735607.pdf (accessed on 29 April 2022).

[2] Wright, M.; Lin, A.; O’Connell, M. Humility, inquisitiveness, and openness: Key attributes for meaningful engagement with Nyoongar people. Adv. Ment. Health 2016, 14, 79–81. https://www.tandfonline.com/doi/abs/10.1080/18387357.2016.1173516

[3] World Health Organisation (WHO). Bangkok Charter of Health Promotion in a Globalized World. 2008. Available online: https://apps.who.int/iris/bitstream/handle/10665/205976/B3280.pdf (accessed on 29 April 2022).

Dr. Michael Wright
Guest Editor

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Keywords

  • health promotion
  • Australian First Nations mental and physical health
  • social, emotional, mental and spiritual wellbeing
  • social and mental and spiritual health determinants
  • decolonising mental health and health systems

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Published Papers (9 papers)

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Research

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12 pages, 474 KiB  
Article
Facilitators and Barriers to Implementing a Community Suicide Database and Prevention Program in Diverse Tribal Communities
by Meredith Stifter, Novalene Goklish, Charity Watchman, Kristin Mitchell, Jennifer Duncan, Michelle Miller, Mary HorseChief, Christopher G. Kemp, Mary Cwik and Emily E. Haroz
Int. J. Environ. Res. Public Health 2024, 21(12), 1616; https://doi.org/10.3390/ijerph21121616 - 3 Dec 2024
Viewed by 398
Abstract
Suicide is the second leading cause of death for American Indian youth, far surpassing the rates of suicide experienced by other races. The White Mountain Apache Tribe has made significant impacts on suicide risk by implementing a robust suicide prevention program which includes [...] Read more.
Suicide is the second leading cause of death for American Indian youth, far surpassing the rates of suicide experienced by other races. The White Mountain Apache Tribe has made significant impacts on suicide risk by implementing a robust suicide prevention program which includes a community-led database and case management follow-ups. Due to the success of the program in preventing suicides, the White Mountain Apache team has worked with other tribal communities to adapt the program. We wanted to understand the factors that are most important to implementing and sustaining this model and how these factors compare with existing implementation science frameworks. We employed an adapted nominal group technique to compile facilitators and barriers to implementation of the suicide prevention model across settings with five partner teams. Two researchers independently coded the resulting list of facilitators and barriers using the Consolidated Framework for Implementation Research (version 1.0) codebook. The final list of cross-site prioritized facilitators and barriers included 41 factors. Some factors did not match easily with the framework’s constructs. The White Mountain Apache suicide prevention team noted that seven of the top prioritized factors are considerations they most try to emphasize to new communities working in suicide prevention. The factors fall into two key themes: staffing and tribal engagement. This finding affirms their focus when they conduct suicide prevention trainings with new communities and provides an opportunity for more structure and in-depth training in those two areas. Several factors could not be easily coded to the framework, especially around the sociocultural characteristics of suicide prevention work in Native communities. This contributes to the larger discussion in implementation science concerning the ways in which Indigenous approaches to public health differ from Western models. Full article
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18 pages, 1099 KiB  
Article
Community-Engaged Development of Strengths-Based Nutrition Measures: The Indigenous Nourishment Scales
by Tara L. Maudrie, Laura E. Caulfield, Cassandra J. Nguyen, Melissa L. Walls, Emily E. Haroz, Laura R. Moore, Rachel G. Dionne-Thunder, Joe Vital, Brook LaFloe, Alanna Norris, Vincent Dionne, Virgil Pain On Hip, Jessica Dickerson, Kerry Hawk Lessard, Antony L. Stately, Valarie Blue Bird Jernigan and Victoria M. O’Keefe
Int. J. Environ. Res. Public Health 2024, 21(11), 1496; https://doi.org/10.3390/ijerph21111496 - 11 Nov 2024
Viewed by 929
Abstract
Mainstream approaches to nutrition typically focus on diet consumption, overlooking multi-dimensional aspects of nutrition that are important to American Indian/Alaska Native (AI/AN) communities. To address health challenges faced by AI/AN communities, strengths-based measures of nutrition grounded in community worldviews are needed. In collaboration [...] Read more.
Mainstream approaches to nutrition typically focus on diet consumption, overlooking multi-dimensional aspects of nutrition that are important to American Indian/Alaska Native (AI/AN) communities. To address health challenges faced by AI/AN communities, strengths-based measures of nutrition grounded in community worldviews are needed. In collaboration with AI/AN communities in Baltimore and Minneapolis, we developed the Indigenous Nourishment Scales through three phases. Phase 1 involved focus group discussions with nine community-research council (CRC) members (n = 2) and four in-depth interviews (n = 4) to gather perspectives on existing models of nutrition. Phase 2 refined scales through two additional focus group discussions (n = 2) with a total of nine participants and two in-depth interviews (n = 2). Finally, in Phase 3, we held ten (n = 10) cognitive interviews with AI/AN community members to refine the scales. Participants appreciated the measures’ ability to provoke reflection on their relationship with nutrition and suggested adjustments to better capture cultural nuances, such as incorporating concepts like “being a good relative” to land. The Indigenous Nourishment Scales represent a departure from conventional approaches by encompassing multiple dimensions of nourishment, offering a framework that addresses epistemic injustices in nutrition measurement and grounds health measurement efforts directly in community perspectives and worldviews. Full article
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15 pages, 330 KiB  
Article
Factors Influencing Behaviors to Reduce the Spread of COVID-19 Among Indigenous Families in the Southwest, United States
by Habibat A. Oguntade, Miya Pontes, Karlita Pablo, Elliott Pablo, Novalene Goklish, Meredith Stifter, Lauren Tingey, Allison Barlow, Laura L. Hammitt and Mary Cwik
Int. J. Environ. Res. Public Health 2024, 21(11), 1407; https://doi.org/10.3390/ijerph21111407 - 24 Oct 2024
Viewed by 873
Abstract
Indigenous communities in the United States (U.S.) have been disproportionately impacted by COVID-19, yet they have led efforts to combat the pandemic by providing local solutions that minimize viral transmission and promote vaccine uptake. Understanding facilitators and barriers to recommended behaviors can increase [...] Read more.
Indigenous communities in the United States (U.S.) have been disproportionately impacted by COVID-19, yet they have led efforts to combat the pandemic by providing local solutions that minimize viral transmission and promote vaccine uptake. Understanding facilitators and barriers to recommended behaviors can increase adherence and reduce COVID-19 transmission. We conducted a descriptive qualitative study using in-depth interviews with 19 Indigenous adults residing on Tribal Lands in the Southwest U.S. between June and December 2021. Interview questions explored obstacles and motivators to testing, as well as behavioral recommendations to reduce COVID-19 transmission and increase vaccination. Using a qualitative content analysis approach, we identified barriers and facilitators to behavioral change. Barriers to testing included fear of exposure to COVID-19 at testing locations and discomfort from nasal swabs. Facilitators of testing were access, required testing, and protecting loved ones. Barriers to vaccination were discouraging stories about vaccination side effects and uncertainty about the ingredients and effectiveness of vaccines. Another barrier to vaccination was confusion and fairness related to vaccine eligibility, which discouraged some people from becoming vaccinated, despite intentions to do so. This study identified obstacles and motivators influencing COVID-19 testing and vaccination. The results may help address information gaps and improve public health efforts to reduce COVID-19 transmission and other similar infectious agents in Indigenous communities. Full article
23 pages, 2453 KiB  
Article
Introducing ‘Ngaruroro’, a New Model for Understanding Māori Wellbeing
by Finley Ngarangi Johnson, Priscilla Wehi, Tia Neha, Mike Ross, Veronica Thompson, Stephanie Tibble, Natasha Tassell-Matamua, Kevin Shedlock, Ririwai Fox, Zachary Penman, Tyler Ritchie, Taylor Winter, Hitaua Arahanga-Doyle and Paul E. Jose
Int. J. Environ. Res. Public Health 2024, 21(4), 445; https://doi.org/10.3390/ijerph21040445 - 5 Apr 2024
Viewed by 4483
Abstract
Indigenous peoples around the world are revitalising their ancestral beliefs, practices, and languages, including traditional understandings of health and wellbeing. In the Aotearoa (New Zealand) context, a number of ground-breaking Māori health- and wellbeing-related models have emerged, each with their own scope and [...] Read more.
Indigenous peoples around the world are revitalising their ancestral beliefs, practices, and languages, including traditional understandings of health and wellbeing. In the Aotearoa (New Zealand) context, a number of ground-breaking Māori health- and wellbeing-related models have emerged, each with their own scope and applications. We sought in our qualitative studies to explore and identify several key sources of wellbeing for Māori individuals. Nine interviews were conducted with members of Māori communities to identify key themes of Māori wellbeing. We performed a Reflexive Thematic Analysis on these data and then conducted a further fifteen interviews to revise, refine, and reposition the previously generated themes. The Ngaruroro model describes wellbeing as the embodied and active process of being well in relation with one’s (1) here tāngata (social and familial ties), (2) te taiao (the environment), and (3) taonga tuku iho (cultural treasures) while doing what one can to make lifestyle choices that are conducive to the health of one’s (4) tinana (body) and (5) wairua (spirit) while cultivating a balanced (6) ngākau (inner-system), fulfilling (7) matea (core needs) and exercising your (8) mana (authority). These themes illustrate that Māori wellbeing is dynamic, interconnected, and holistic. Full article
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16 pages, 369 KiB  
Article
Developing and Implementing a Culturally Consonant Treatment Fidelity Support Plan with the Apsáalooke Nation
by Shannen Keene, Sarah Allen, Alma Knows His Gun McCormick, Coleen Trottier, Brianna Bull Shows, John Hallett, Rae Deernose and Suzanne Held
Int. J. Environ. Res. Public Health 2023, 20(21), 6989; https://doi.org/10.3390/ijerph20216989 - 28 Oct 2023
Viewed by 1638
Abstract
Treatment fidelity remains underreported in health intervention research, particularly among Indigenous communities. One explanation for this gap is the lack of culturally consonant strategies listed in the National Institutes of Health (NIH) Behavior Change Consortium (BCC) treatment fidelity framework, the gold standard for [...] Read more.
Treatment fidelity remains underreported in health intervention research, particularly among Indigenous communities. One explanation for this gap is the lack of culturally consonant strategies listed in the National Institutes of Health (NIH) Behavior Change Consortium (BCC) treatment fidelity framework, the gold standard for understanding and measuring fidelity. This paper focuses on the development and implementation of a culturally consonant treatment fidelity support plan across two of the five BCC fidelity areas, provider training and treatment delivery, within a chronic illness self-management program for the Apsáalooke (Crow) Nation. Our team selected and adapted strategies from, and added strategies to, the BCC framework, that centered on relational accountability and the Apsáalooke culture. To be culturally consonant, we approached treatment fidelity as supporting Aakbaabaaniilea (Apsáalooke program facilitators) rather than monitoring them. This resulted in the development of a fifth treatment fidelity area: building and fostering relationships. We propose that fidelity to relational accountability is the foundation of successful programs in Indigenous communities. This suggests an important shift from tracking what was conducted in an intervention to prioritizing how things were conducted. We encourage others to view the BCC framework as a starting point in developing fidelity strategies that are consonant with local cultures. Full article
14 pages, 740 KiB  
Article
“Ngany Kamam, I Speak Truly”: First-Person Accounts of Aboriginal Youth Voices in Mental Health Service Reform
by Hunter Culbong, Ashton Ramirez-Watkins, Shae Anderson, Tiana Culbong, Nikayla Crisp, Glenn Pearson, Ashleigh Lin and Michael Wright
Int. J. Environ. Res. Public Health 2023, 20(11), 6019; https://doi.org/10.3390/ijerph20116019 - 31 May 2023
Cited by 3 | Viewed by 2926
Abstract
Aboriginal young people are experts in their own experience and are best placed to identify the solutions to their mental health and wellbeing needs. Given that Aboriginal young people experience high rates of mental health concerns and are less likely than non-Indigenous young [...] Read more.
Aboriginal young people are experts in their own experience and are best placed to identify the solutions to their mental health and wellbeing needs. Given that Aboriginal young people experience high rates of mental health concerns and are less likely than non-Indigenous young people to access mental health services, co-design and evaluation of appropriate mental health care is a priority. Increasing Aboriginal young people’s participation in mental health service reform is key to ensuring services are culturally secure, relevant and accessible. This paper presents first-person accounts from three Aboriginal young people who worked alongside their Elders and in a positive and constructive partnership with mainstream mental health services on a three-year participatory action research project in Perth, Western Australia, in Whadjuk Nyoongar boodja (Country). The young people recount their experiences as participants and co-researchers on a systems change mental health research project and share their views on the importance of privileging Aboriginal youth voices. Their accounts highlight that Aboriginal young people’s participation and leadership must be understood through a decolonising lens and that working in genuine partnership with the community is key to increasing their contact and engagement with mental health care and improving mental health and wellbeing outcomes. Full article
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16 pages, 6781 KiB  
Commentary
Strong Born—A First of Its Kind National FASD Prevention Campaign in Australia Led by the National Aboriginal Community Controlled Health Organisation (NACCHO) in Collaboration with the Aboriginal Community Controlled Health Organisations (ACCHOs)
by Robyn Williams, Sarah Hayton, Annabel Campbell, Holly Kemp and Dorothy Badry
Int. J. Environ. Res. Public Health 2024, 21(1), 85; https://doi.org/10.3390/ijerph21010085 - 11 Jan 2024
Cited by 1 | Viewed by 3214
Abstract
The Strong Born Campaign (2022–2025) was launched by the National Aboriginal Community Controlled Health Organisation (NACCHO) in 2023. Strong Born is the first of its kind national Aboriginal and Torres Strait Islander health promotion campaign to address Fetal Alcohol Spectrum Disorder (FASD) within [...] Read more.
The Strong Born Campaign (2022–2025) was launched by the National Aboriginal Community Controlled Health Organisation (NACCHO) in 2023. Strong Born is the first of its kind national Aboriginal and Torres Strait Islander health promotion campaign to address Fetal Alcohol Spectrum Disorder (FASD) within Australia. Strong Born was developed to address a longstanding, significant gap in health promotion and sector knowledge on FASD, a lifelong disability that can result from alcohol use during pregnancy. Utilizing a strengths-based and culturally sound approach, NACCHO worked closely with the Aboriginal Community Controlled Health Organisations (ACCHOs) to develop the campaign through co-design, as described in this paper. Since its inception, the ACCHOs have continually invested in driving change towards improvements in Aboriginal health determinants and health promotion. The Strong Born Campaign developed culturally safe health promotion tool kits designed for the community and health sector staff and also offered communities the opportunity to apply for FASD Communications and Engagement Grants to engage in local campaign promotion. The tool kits have been disseminated to 92 ACCHOs across Australia. This paper describes the development of the Strong Born Campaign and activities following its launch in February 2023 from an Indigenous context within Australia, as described by NACCHO. Full article
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8 pages, 489 KiB  
Perspective
The Other Side of the ACEs Pyramid: A Healing Framework for Indigenous Communities
by Maegan Rides At The Door and Sidney Shaw
Int. J. Environ. Res. Public Health 2023, 20(5), 4108; https://doi.org/10.3390/ijerph20054108 - 25 Feb 2023
Cited by 4 | Viewed by 5238
Abstract
For over two decades, extensive research has demonstrated significant associations between adverse childhood events (ACEs) and a wide range of negative health, mental health, and social outcomes. For Indigenous communities globally, colonization and historical trauma are commonly associated with ACEs, and these effects [...] Read more.
For over two decades, extensive research has demonstrated significant associations between adverse childhood events (ACEs) and a wide range of negative health, mental health, and social outcomes. For Indigenous communities globally, colonization and historical trauma are commonly associated with ACEs, and these effects reverberate through generations. While the ACEs conceptual framework expanded pyramid is a useful model and a visual aid for understanding the historical and present-day dimensions of ACEs in Indigenous communities, a healing conceptual framework is needed to outline a path toward increased community well-being. In this article, we provide a holistic Indigenous Wellness Pyramid that represents the other side of the ACEs pyramid to guide pathways toward healing in Indigenous communities. In this article, the authors describe the Indigenous Wellness Pyramid according to each of the following contrasts with the ACEs pyramid: Historical Trauma—Intergenerational Healing/Indigenous Sovereignty; Social Conditions/Local Context—Thriving Economic and Safe Communities; ACEs—Positive Childhood, Family, and Community Experiences; Disrupted Neurodevelopment—Consistent Corrective Experiences/Cultural Identity Development; Adoption of Health Risk Behaviors—Cultural Values and Coping Skills; Disease Burden and Social Problems—Wellness and Balance; Early Death—Meaningful Life Longevity. We provide examples, supporting research, and implications for implementing the Indigenous Wellness Pyramid. Full article
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12 pages, 597 KiB  
Concept Paper
Te Maramataka—An Indigenous System of Attuning with the Environment, and Its Role in Modern Health and Well-Being
by Isaac Warbrick, Rereata Makiha, Deborah Heke, Daniel Hikuroa, Shaun Awatere and Valance Smith
Int. J. Environ. Res. Public Health 2023, 20(3), 2739; https://doi.org/10.3390/ijerph20032739 - 3 Feb 2023
Cited by 7 | Viewed by 14582
Abstract
The connection between the natural environment and human health is well documented in Indigenous narratives. The maramataka—a Māori system of observing the relationships between signs, rhythms, and cycles in the environment—is underpinned by generations of Indigenous knowledge, observation, and experimentation. The maramataka enabled [...] Read more.
The connection between the natural environment and human health is well documented in Indigenous narratives. The maramataka—a Māori system of observing the relationships between signs, rhythms, and cycles in the environment—is underpinned by generations of Indigenous knowledge, observation, and experimentation. The maramataka enabled Māori and our Pacific relatives to attune with the movements of the environment and ensure activities essential for survival and well-being were conducted at the optimal times. A recent revival of the maramataka in various communities in New Zealand is providing uniquely Indigenous ways to ‘reconnect’ people, and their health, with the natural environment. In a world where people have become increasingly disconnected from the natural environment, the maramataka offers an alternative to dominant perspectives of health. It also provides a mechanism to enhance the many facets of health through an understanding of the human–ecosystem relationship in a uniquely Indigenous way. This conceptual paper (i) highlights a uniquely Indigenous way of understanding the environment (the maramataka) and its connection to health, (ii) discusses the connections between the maramataka and scientific research on health and the environment, and (iii) introduces current and potential applications of the maramataka in improving health and well-being. Full article
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