Search Results (543)

Background/Objectives: University Department of Rural Health (UDRH) programs were created to address the disparities in rural Australian communities. A large proportion of Aboriginal and Torres Strait Islander people live in rural communities, and the UDRHs work closely with communities to improve outcomes for Indigenous Australians. This narrative review examines the nature of the intervention papers in Australian Indigenous health published by UDRHs and identifies key learnings to improve interventions in Australian Indigenous health. Methods: Intervention papers were identified from an established database of UDRH Indigenous health-related publications published 2010–2021. Results: Thirty-three papers were included in the review. Thematic analysis identified four overarching themes from the key learnings identified in the papers: (1) principles of engagement and design; (2) considerations for improving healthcare systems; (3) considerations for improving healthcare workforce; and (4) the sustainability of interventions and improvements in outcomes. Most of the studies employed qualitative or mixed-methods designs. Conclusions: These findings provide practical guidance for strengthening Indigenous health interventions. Effective Indigenous health interventions require meaningful community engagement and co-design, culturally safe practice supported by workforce training, and multicomponent approaches that address social determinants and barriers to access. Sustained impact depends on adequate resourcing, strong organisation leadership and embedding programs within healthcare systems with clear pathways for ongoing care and capacity building. UDRHs should reflect on current and future projects to ensure that engagement principles, system-level considerations, health workforce development, and long-term sustainability are embedded within intervention design and implementation. Full article

Indigenous Australians experience a disproportionate burden of type 2 diabetes mellitus and cardiovascular disease. While clinician-led, community-based exercise programs are effective in general populations, limited peer-reviewed evidence is available describing culturally adapted exercise interventions with Indigenous Australians that transparently reports governance, cultural adaptation, and theoretical design. This paper reports the co-design and development of tools for the Preventing Indigenous Cardiovascular Disease and Diabetes through Exercise (PrIDE) study, an adaptation of the Beat It program that incorporates wearable technology. Using the Co-design Health Research and Innovation Model, four tools were developed with Indigenous governance through a Consumer Advisory Group and a project-specific Consumer User Panel. Three tools were culturally adapted—the PrIDE Exercise Program, the Strong Spirit Strong Self self-efficacy assessment, and Keep Your Heart Strong educational materials—and a newly developed tool, the Success Plan. Cultural adaptations were prospectively documented using the Model for Adaptation Design and Impact, and all tools were assessed using the Aboriginal and Torres Strait Islander Quality Appraisal Tool. Behavior change mechanisms were mapped using the COM-B model. This paper provides transparent documentation of culturally adapted theory-informed tool development to support reproducibility and knowledge translation. The evaluation of effectiveness, acceptability, and psychometric properties will be reported following PrIDE implementation. Full article

Background: This study compared the reasons for dental presentations between Indigenous and non-Indigenous Australian adults at the Nepean Centre for Oral Health, NSW, Australia. Methods: A retrospective cohort study was conducted on adult patients presenting between 1 July and 31 December 2019. Clinical notes were audited and categorized as either ‘emergency’ (pain, dental infection, dental trauma, loose teeth or dental implants, bleeding) or ‘conservative’ (dental check-ups, examinations, prosthodontic, restorative, periodontal, or non-emergency endodontic therapy). Results: A total of 4663 patients met the inclusion criteria; 61.6% were female, and 6.4% were identified as Indigenous Australians. Overall, 41.3% of presentations were for emergency dental care. Indigenous Australians were significantly more likely to present for dental emergencies compared with non-Indigenous (58.2% vs. 40.2%; χ²(1, N = 4663) = 53.4, p < 0.00001; OR = 2.07, 95% CI: 1.64–2.63), and were also more likely to undergo emergency tooth extractions (p < 0.05). Conclusions: Indigenous Australians demonstrated a higher proportion of emergency and oral surgery-related presentations and underwent tooth extractions as the primary treatment compared to their non-Indigenous counterparts. These findings suggest a higher burden of oral disease and delayed access to general dental services among Indigenous Australians, highlighting the need for targeted and culturally appropriate public health interventions. Full article

Background: Children’s development is dependent on a range of factors influencing their life course outcomes. Protective and challenging social and cultural determinants impact how Indigenous families support their children’s developmental foundations. However, there is a lack of international evidence investigating Indigenous child development interventions. To gain a perspective across nations with comparable settler-colonial histories, this scoping review summarised studies on family and community-centred approaches among Indigenous populations in Australia, Canada, New Zealand, and the United States, focusing on outcomes and evidence gaps. Methods: A scoping review followed PRISMA-ScR guidelines. Medline, CINAHL, and PsycINFO (Ovid) were searched from their inception to October 2025, including grey literature sources from Aboriginal HealthInfoNet, the Lowitja Institute and the Secretariat of National Aboriginal and Islander Child Care. Empirical studies, including quantitative, mixed-methods, evaluation studies, and descriptive or case-study designs, were included provided they reported empirical data on intervention outcomes. Due to study heterogeneity, data were synthesised narratively. Results: Following screening of 2355 records, eight from 2013 to 2020 met the inclusion criteria. These were mostly small-scale, non-randomising designs evaluating different interventions, with the behavioural and emotional domain being the most frequently assessed outcome, alongside developmental vulnerability and academic/educational areas. There was limited consideration of protective cultural determinants of health in the study design and implementation. Six studies reported positive associations between interventions or programmes and early childhood development outcomes. Conclusions: While the number and rigour of identified interventions were limited, several demonstrated potential benefits for Indigenous children’s early childhood development. However, strengthening the evidence base requires culturally grounded, adequately powered evaluations using rigorous study designs that include culturally co-designed adaptations conducted with Indigenous families and communities. Support is recommended for capacity building and funding. Full article

Tourism and destination healthcare systems are increasingly interdependent, yet this relationship remains weakly conceptualised within tourism and hospitality research. Expanding travel flows introduce transient populations, seasonal demand volatility, and distinctive risk profiles that reshape local healthcare demand, while healthcare capacity and governance have become critical enabling conditions for destination resilience and competitiveness. This conceptual paper synthesises contemporary research and practice-based evidence to develop an integrated framework explaining how tourism development and healthcare systems co-evolve. Using a narrative review and conceptual synthesis approach, the framework is informed by two contrasting destination contexts: Phuket, Thailand, a high-volume international and medical tourism hub, and Australia’s Northern Territory, a low-density remote tourism region reliant on aeromedical retrieval and public health services. The proposed framework identifies three interlinked pillars—tourism pressure pathways, health system response capacities, and opportunity leverage mechanisms—positioning healthcare systems as core tourism infrastructure and health system resilience as a central dimension of sustainable destination governance. The framework offers a transferable analytical tool to support tourism planning, health policy integration, and cross-sectoral governance across diverse destination settings. Full article

This article draws on my doctoral research, Reconciliation Rescue: An Original Blak Comedy Series and Aboriginal Cultural Perspectives on Humour, to examine how Aboriginal humour operates as a mode of resistance, truth-telling, and cultural continuity. My thesis consists of two components Reconciliation Rescue, an original scripted Blak comedy series, and an accompanying exegesis that situates the work within broader discussions of Aboriginal sovereignty, identity, and the politics of reconciliation. In this article, I extend that research to demonstrate how Aboriginal voices, when centred in comedic storytelling, challenge colonial paradigms and reframe national narratives. Grounded in my lived experience as an Aboriginal woman and my longstanding creative practice, I explore the ways in which Aboriginal humour addresses intergenerational trauma, racism, and stereotypes. I contrast the collectivist values and relational worldviews of Aboriginal cultures with the individualism of Whitestream society, arguing that humour particularly the oration of humorous storytelling has long served as a powerful tool of healing, resilience, and community cohesion. This distinctive form of ‘Blak Humour’ confronts harmful assumptions, empowers our people, and strengthens cultural identity. By reflecting on the development of Reconciliation Rescue and the principles that shape First Nations comedic expression, this article illustrates how Aboriginal comedy can act as an educational and transformative force. It highlights humour’s potential to foster understanding, unsettle entrenched power structures, and contribute meaningfully to more culturally informed and socially just approaches to reconciliation in Australia. Full article

Chronic diseases disproportionately impact Indigenous peoples in Australia, with type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) representing leading causes of morbidity and mortality. Despite evidence supporting community-based exercise interventions for T2DM management, no culturally adapted programs utilizing wearable technology have been co-designed specifically with Indigenous Australian communities. This study protocol aims to determine if wearable-based exercise interventions can effectively prevent CVD development and manage T2DM progression in Indigenous Australians through culturally safe, community-led approaches. The PrIDE study protocol describes a mixed-methods translational research design incorporating Indigenous and Western methodologies across three phases: (1) co-designing culturally adapted exercise programs and assessment tools, (2) implementing interventions with wearable monitoring, and (3) conducting evaluation and scale-up assessment. Sixty-four Indigenous Australian adults with T2DM will be recruited across remote, rural/regional sites to self-select into either individual or group exercise programs using the Withings ScanWatch 2. Primary outcomes include cardiovascular risk factors, physical fitness, and health self-efficacy measured using culturally adapted tools. Indigenous governance structures will ensure cultural safety and community ownership throughout. The PrIDE protocol presents a novel approach to improving health equity while advancing understanding of wearable technology integration in Indigenous healthcare, informing future larger-scale trials and policy development. Full article

First Nations children remain dramatically over-represented in Australia’s Out-of-Home Care (OOHC) system, particularly in New South Wales (NSW), which continues to report the highest numbers nationally. This narrative review, grounded in a relational First Nations Standpoint Theory and decolonising research paradigms, to critically examine the systemic, structural, and historical factors contributing to these disproportionalities. Drawing on interdisciplinary evidence across law, criminology, education, health, governance studies, and public policy, the analysis centres Indigenous-authored scholarship and contemporary empirical literature, including grey literature, inquiries, and community-led reports. Findings reveal that the OOHC system reproduces the colonial logics that historically drove the Stolen Generations. Macro-level structural drivers—including systemic racism, Indigenous data injustice, entrenched poverty and deprivation, intergenerational trauma, and Westernised governance frameworks—continue to shape child protection policies and practices. Micro-level drivers such as parental supports, mental health distress, substance misuse, family violence, and the criminalisation of children in care (“crossover children”) must be understood as direct consequences of structural inequality rather than as isolated individual risk factors. Current placement and permanency orders in NSW further compound cultural disconnection, with ongoing failures to implement the Aboriginal and Torres Strait Islander Child Placement Principle (ATSICPP). Contemporary cultural rights and Indigenous Cultural and Intellectual Property (ICIP) frameworks highlight the urgency of restoring Indigenous authority in decision-making processes. The literature consistently demonstrates that cultural continuity, kinship networks, and ACCO-led models are sort to produce stronger long-term outcomes for children. The review concludes that genuine transformation requires a systemic shift toward Indigenous-led governance, community-controlled service delivery, data sovereignty, and legislative reform that embeds cultural rights and self-determination. Without acknowledging the structural drivers and redistributing genuine power and authority, the state risks perpetuating a cycle of removal that mirrors earlier assimilationist policies. Strengthening First Peoples governance and cultural authority is therefore essential to creating pathways for First Nations children to live safely, remain connected to family and kin, and thrive in culture. Full article

The study’s aim was to compare the unplanned admission rates and nutrition outcomes in patients with head and neck squamous cell cancer (HNSCC) receiving chemoradiotherapy at two different hospitals with different nutrition support approaches. Hospital Site A used prophylactic tube feeding and Site B used reactive tube feeding. Consecutive HNSCC patients receiving chemoradiotherapy with curative intent over six months in 2015 were eligible for this prospective comparative cohort study. Only patients who were classified as at high nutrition risk using validated guidelines were included. Patients’ weight was recorded at the start, end, and 4–6 weeks post treatment to determine percentage weight loss outcomes. Unplanned hospital admissions (for medical or nutrition related reasons) and associated length of stay (LOS) were collected throughout and up to 1-month post treatment. In total, 88 patients were included in the study (site A n = 58; site B n = 30). The mean age was 60 years, 86–90% were male, and predominantly had oropharyngeal cancer. There was no statistical difference between the groups for percentage weight loss at any timepoint, rates of unplanned nutrition related admissions, or LOS. Stepwise logistic analysis showed that being of an older age was predictive of having an unplanned nutrition-related admission. In summary, there was no difference in the rate of unplanned admissions or percentage weight loss for patients with HNSCC managed under the prophylactic versus reactive tube feeding approach. Decision making regarding the choice of feeding tube should be made in consultation with the patient and the multidisciplinary team. Full article

Background: Global declines in immunisation rates and a resurgence in measles pose a threat, even in countries like Australia that have achieved elimination status. National coverage in Australia is measured at static timepoints, so it is unclear at what age children received their vaccines. This may permit the emergence of immunity gaps, leaving children susceptible to measles between those reporting timepoints. Methods: A cross-sectional retrospective analysis was conducted using routinely collected data from the Australian Immunisation Register for children residing in Hunter New England Local Health District (HNELHD), New South Wales, born from 1 January 2015 to 1 June 2019 as a quality improvement initiative. Coverage, age at immunisation, and on-time immunisation were described by demographic, local geographic and age variables. Reverse survival analysis was conducted to determine the timing of achieving 95% MCV2 coverage. To ensure the cultural integrity of the research, an Aboriginal researcher co-led the design, analysis and interpretation of results. Results: The analysis included 53,390 children. Measles coverage exceeded the national and international target of 95% MCV2 coverage, with coverage in Aboriginal children surpassing national rates for all children. Pockets of low coverage were identified in several smaller geographic areas and subpopulations. Median age of MCV1 receipt was 375 days (IQR: 369–390 days), and MCV2 was 560 days (IQR: 551–583 days). More recent birth cohorts had earlier immunisation. On-time immunisation rates were high, and most children receiving measles immunisation late were still immunised within six months of the schedule date. The 95% MCV2 coverage threshold was achieved at 1582 days of age. Conclusions: Robust measles immunisation coverage and timeliness were found in HNELHD, Australia. Timeliness data analysis is a useful adjunct to static coverage data in understanding immunisation protection. Improving immunisation data availability, accessibility, and timeliness offers potential to better inform targeted public health activity. Full article

The first generation of non-Aboriginal children born into the First Nations/Aboriginal country had their own relationship to colonising. For them, Aboriginal people were negotiated as part of play. The children escaped the strictures of work or classroom to spend time at the Aboriginal camps located near the homesteads, or to indicate Aboriginal presence on the stations. The locating of First Nations/Aboriginal people as part of play had an influence on the way non-Aboriginal people related to Aboriginal people and politics in Australian history. Full article

This qualitative comparative case study examines how culturally grounded philosophies of education shape the teaching and learning of reading in two cross-cultural contexts—an Aboriginal Australian classroom and urban Chinese elementary schools. Drawing on interpretive and reflexive methodologies, it investigates how Aboriginal and Confucian epistemologies influence literacy practices and how these practices align with or resist dominant, decontextualized models of reading instruction. Data sources include classroom observations, reading assessments, teacher interviews, and researcher reflections. Conceptually framed by Gadamer’s hermeneutics, Bourdieu’s theory of cultural capital, Habermas’s typology of knowledge, and the Caribbean concept of overstanding, this research finds that Aboriginal literacy is embedded in relational, land-based knowledge systems, whereas Chinese literacy instruction reflects moral discipline and social hierarchy rooted in Confucian traditions. This study introduces overstanding as a pedagogical stance that foregrounds ethical engagement, cultural respect, and mutual understanding. By challenging universalist models of literacy, this research offers a framework for developing dialogical, culturally responsive, and equity-oriented reading practices. Full article

This paper contains an overview of the human colonisation of Australasia and Oceania over the last 65,000 years, and highlights the resultant diversity of settlement types, place and cultural landscape formations, and architectural solutions, but simultaneously gives attention to the long-term retention of particular traditions throughout the study region. The time, geographic and multi-cultural scales are thus vast, implying this is a study in the category of ‘deep history’. However, the author has drawn from his editing of the regional volume of ‘Australasia and Oceania,’ for the 2nd edition of the Encyclopaedia of Vernacular Architecture of the World, or EVAW 2, containing some 200 contributions on this region. Two migratory events are explored. The first is that of Aboriginal people into Australia some 65,000 years ago. The second is the Austronesian migrations into the Pacific Ocean from 5000 to 1500 BP. Despite millennia of cultural, environmental, climatic, economic and warfare disruptions, a series of continuities of tradition are identified and analysed in a limited manner due to the brevity of the paper. However, the paper provides a significant contribution in making such a broad-scale holistic overview of the pattern languages of building traditions that link communities in Oceania and Australasia arising from past migrations and drawing on multi-disciplinary sources. Full article

Genealogy is a powerful analytical framework for understanding the cultural evolution of tribes, communities, and societies. This article demonstrates that the recurrent reliance on genealogical structures is a common feature of human societies, serving as a fundamental mechanism for cultural evolution through time, space, and culture. Based on comparative analysis of indigenous tribal societies (e.g., Aboriginal Australian kinship, Polynesian chiefly genealogies), agrarian civilizations (e.g., European feudal lineages, Chinese patriliny), and modern nation-states (e.g., nationalist mythmaking, DNA-based ancestry movements), this study reveals consistent patterns in genealogical functions. Drawing on an interdisciplinary perspective from anthropology, sociology, history, and evolutionary biology, it is argued that genealogical systems are not passive records of descent but dynamic forces of cultural continuity and adaptation. The evidence shows that, despite vast sociocultural differences, genealogy widely operates as a dual-purpose instrument. It preserves cultural memory and legitimizes political authority while simultaneously facilitating social adaptation and innovation in response to new challenges. The paper also critiques contemporary trends like commercial genetic genealogy, highlighting its potential for reconnecting diasporic communities alongside its risks of biological essentialism. Ultimately, the work establishes that the persistent and patterned reliance on genealogy from oral traditions to genetic data offers a critical lens for understanding the deep structures of cultural continuity and transformation in human societies. It further underscores the importance of genealogy in cultural evolution, historical persistence, societal transformation, and the construction of belonging in an increasingly globalized world. Full article

Background: Childhood Obesity is a significant and growing Public Health threat among Aboriginal and Torres Strait Islander (ATSI) children and adolescents in Australia. Health sectors in Australia have been focusing on health intervention programs across various states to prevent childhood obesity. This review aims to analyse the impact of obesity intervention programs conducted among children and adolescents of ATSI communities across Australia and report on the best practices for conducting future research. Objectives: This scoping review synthesised existing literature on the obesity prevention interventions programs among ATSI Children and Adolescents in Australia and examined their scope, implementation, and outcomes; evaluated their cultural appropriateness; and highlighted critical enablers and barriers. Methods: This scoping review analysed scholarly journal articles that reported on the findings of obesity intervention programs delivered across ATSI children and adolescents. Only Quasi-experimental and Randomized Control Trials (RCTs) were selected for the review. A full search has been carried out in Health databases such as Cochrane Library, Medline, PubMed, and ProQuest Central for the past 15 years. The framework of the Joanna Briggs Institute (JBI) for Scoping reviews was followed throughout this review. Results: Eleven studies met inclusion criteria. Findings were clustered into five themes: (i) community-led, systems-based interventions improved health behaviours and anthropometry; (ii) culturally tailored, community-embedded programs enhanced engagement and health literacy; (iii) early childhood and family-focused approaches showed promise; (iv) community or policy initiatives yielded mixed results; and (v) behavioural interventions were ineffective without addressing social and structural determinants. The most effective programs were community-delivered, multi-stakeholder, and centred on empowerment and capacity building. Conclusions: Obesity prevention efforts targeting Aboriginal and Torres Strait Islander children and adolescents are most successful when community-led, culturally grounded, and supported by multiple stakeholders. These findings underscore the necessity of culturally sensitive, participatory approaches. Further research is needed to strengthen the evidence base and inform sustainable, policy-relevant strategies for childhood obesity. Full article