First Nations Health and Wellbeing - The Lowitja Journal最新文献

{"title":"Racism and cultural safety for Indigenous general practice trainees: An exploratory study of how to support training, careers and professional wellbeing","authors":"Talila Milroy (Yindjibarndi and Palyku),&nbsp;Jacqueline Frayne","doi":"10.1016/j.fnhli.2024.100038","DOIUrl":"10.1016/j.fnhli.2024.100038","url":null,"abstract":"<div><h3>Purpose</h3><div>Racism as a social determinant of health has known impacts on the physical and mental health of Indigenous peoples, which extends to Indigenous doctors in training and is a barrier to the growth of the Indigenous health workforce in Australia. This study aimed to explore racism and cultural safety within the professional experiences of Australian Indigenous general practice (GP) trainees, to elucidate barriers and facilitators to their training, careers and professional wellbeing.</div></div><div><h3>Methods</h3><div>A sequential exploratory mixed methods study was conducted in 2020 and 2021 through an initial quantitative online administered questionnaire followed by qualitative semi-structured interviews with Indigenous GP registrars, from either metropolitan or rural areas, undertaking GP training in Australia. The main outcome measures included online responses to the Measure of Indigenous Racism Experiences (MIRE) questionnaire, which measures several dimensions of racism, and data from thematic analysis of semi-structured interviews undertaken following the online questionnaire.</div></div><div><h3>Main findings</h3><div>The MIRE questionnaire responses revealed experiences of racism across multiple levels. These findings were integrated and expanded with the central themes drawn from the interviews. Themes focused on GP training and training environments and operated across interactions with peers, supervisors and patients. The identified themes were i) cultural identity, with the subthemes of professional wellbeing and professional goals and identity; ii) training challenges, including racism and career development; and iii) training facilitators, including specific support and mentorship.</div></div><div><h3>Principal conclusions</h3><div>Australian Indigenous GP trainees value their cultural identity in relation to their professional goals and wellbeing. However, challenges for trainees centre around the lack of cultural safety and presence of racism, which is pervasive across their professional life. Strategies to address this could include further provision of specific support, specific culturally safe training placements, networking and mentorship.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100038"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring resilience using Strong Souls in the Longitudinal Study of Indigenous Children: Evaluating psychometric properties using a Rasch measurement approach","authors":"Ella Gorman ,&nbsp;Roz Walker ,&nbsp;Helen Davis ,&nbsp;Carrington C.J. Shepherd ,&nbsp;Rhonda Marriott (Nyikina)","doi":"10.1016/j.fnhli.2024.100037","DOIUrl":"10.1016/j.fnhli.2024.100037","url":null,"abstract":"<div><h3>Purpose</h3><div>Rigorously evaluated psychometric instruments are necessary to measure constructs relevant to wellbeing, such as resilience. The availability of high-quality instruments for use with Aboriginal young people in Australia is growing but remains limited. This study used data from the Longitudinal Study of Indigenous Children (LSIC) to psychometrically evaluate the Resilience subscale from the social and emotional wellbeing (SEWB) instrument, Strong Souls, for a nationwide sample of Aboriginal adolescents, using alternative psychometric methods to previous research.</div></div><div><h3>Methods</h3><div>Using a Rasch measurement approach, cross-sectional data from Wave 9 of LSIC were used to ascertain the psychometric properties of the Resilience subscale from Strong Souls. Using the responses from 516 Aboriginal young people (age 11.5 to 13 years) to the 12-item scale, Rasch techniques were applied to determine item independence, response category adequacy, differential item functioning (DIF), person and item reliability, item fit and unidimensionality. Two versions of the instrument were evaluated: the full 12-item version, as completed by participants, and an 8-item version, as recommended for use by previous research based on different psychometric methods.</div></div><div><h3>Main findings</h3><div>Both versions of the instrument met several Rasch model requirements for reliable measurement, including demonstrations of unidimensionality (first off factor construct &lt; 2), item independence (all items Q_3∗ &lt; 0.30), and item fit statistics within an acceptable range (0.60 &lt; X &lt; 1.40). However, both instrument versions displayed less adequate person separation (PSI) and reliability (PRI) statistics (12-item scale: PSI = 1.18, PRI = 0.58; 8-item scale: PSI = 0.71, PRI = 0.33).</div></div><div><h3>Principal conclusions</h3><div>Using a Rasch measurement approach to psychometrically evaluate the Strong Souls Resilience subscale in a sample of Aboriginal young people from LSIC, this study provided novel evidence of the functioning of this popular instrument from an alternative psychometric perspective. With mixed results regarding meeting Rasch recommendations, these findings provide a strong evidence base for psychometric strengths as well as opportunities to improve the robustness of this instrument, and ultimately offer a tool that can more accurately inform services, policy and practice to effectively support resilience and wellbeing in Aboriginal young people.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100037"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What about the soles: We need the primary data in Aboriginal and Torres Strait Islander foot health to ‘Close the Gap’","authors":"James A. Charles (Kaurna) ,&nbsp;Elizabeth Tiernan ,&nbsp;Sara Jones","doi":"10.1016/j.fnhli.2024.100041","DOIUrl":"10.1016/j.fnhli.2024.100041","url":null,"abstract":"","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100041"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"These mob here have integrity; they genuinely care about the people: Service users’ and care providers’ perspectives on enablers of good chronic disease care for Aboriginal and Torres Strait Islander peoples","authors":"Sarah Catherine Bourke (Gamilaroi, Jaru, Gidja) ,&nbsp;Deborah Wong ,&nbsp;Uday Narayan Yadav ,&nbsp;Andrea Timothy ,&nbsp;Chelsea Liu ,&nbsp;Abby-Rose Cox (Kija, Nimanburru) ,&nbsp;Rosemary Wyber","doi":"10.1016/j.fnhli.2025.100063","DOIUrl":"10.1016/j.fnhli.2025.100063","url":null,"abstract":"<div><div>Research about Aboriginal and Torres Strait Islander chronic disease management in primary healthcare services rarely considers the perspectives of service users in identifying what works. This research aimed to elevate the voices of clients and providers from high performing primary healthcare services (termed Lighthouse Services) around Australia about the successes and opportunities for improvement in chronic disease management for Aboriginal and Torres Strait Islander peoples. Seventy-five individuals, representing clients (<em>n</em> = 29), their carers (<em>n</em> = 7) and health providers (<em>n</em> = 39), from four Lighthouse Services participated in in-depth focus groups and interviews conducted by the researchers and local partners. The transcripts of these discussions were reviewed in NVivo 14 (<span><span>https://lumivero.com/products/nvivo/</span><svg><path></path></svg></span>) using reflexive thematic analysis to identify key themes representing their lived experiences.</div><div>Access, Communication, Systems, Hub and spokes, Relationships and Workforce were the six themes chosen to represent the range of personal experiences about what works for managing chronic disease at the primary healthcare level. Services that effectively employed a holistic patient-centred model of care, provided culturally safe spaces and were connected to and involved in the community were viewed as providing good care for their clients. The findings of this study support existing literature and make an important new contribution by focusing on the insights of clients, carers and service providers about what and why different aspects of chronic disease care work. It is suggested that this research approach would be beneficial across a range of other settings (e.g. non-Aboriginal community-controlled health organisations and urban services) and conditions (e.g. acute care, social and emotional wellbeing) to enhance Aboriginal and Torres Strait Islander health outcomes.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100063"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community acceptability of lowering the eligibility age of government funded bowel screening for Aboriginal South Australians to 40 years","authors":"Karla J. Canuto (Naghir Tribe of the Kulkalgul Clan) ,&nbsp;Eugene Warrior (Wirangu, Bungala, Kokatha and Antakerinya) ,&nbsp;Sharon Clarke (Wergaia, Wemba Wemba, Djadwajali and Gunditjmara) ,&nbsp;Nathan Rigney (Ngarrindjeri) ,&nbsp;Jie-Bin Lew ,&nbsp;Eleonora Feletto ,&nbsp;Katina D’Onise","doi":"10.1016/j.fnhli.2025.100045","DOIUrl":"10.1016/j.fnhli.2025.100045","url":null,"abstract":"<div><h3>Purpose</h3><div>Building on a study that found that lowering the age of bowel screening for Aboriginal and Torres Strait Islander peoples to 40 years would be cost-effective, this research examined the acceptability of lowering the bowel screening age for Aboriginal and Torres Strait Islander peoples in South Australia.</div></div><div><h3>Methods</h3><div>Aboriginal community members aged &lt; 50 years were recruited to form Aboriginal men’s (16 men) and women’s (nine women) bowel cancer screening councils. The councils were presented with detailed information relating to the topic and deliberated over two days.</div></div><div><h3>Main findings</h3><div>The men’s and women’s councils were unanimous in their support for reducing the age of bowel screening for Aboriginal and Torres Strait Islander peoples. The councils identified barriers to reducing the age at participation, and participation in screening in general. Both councils were highly engaged in the process of the two-day deliberation.</div></div><div><h3>Principal conclusions</h3><div>Lowering the age range for Aboriginal and Torres Strait Islander peoples participating in the bowel screening program to 40 years was acceptable to both Aboriginal bowel cancer screening councils.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100045"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Aboriginal children’s social and emotional wellbeing: Development and validation of a new tool in an Aboriginal cohort study","authors":"Arwen Nikolof ,&nbsp;Deirdre Gartland ,&nbsp;Karen Glover ,&nbsp;Cathy Leane ,&nbsp;Rohan Carmody ,&nbsp;Heather Carter ,&nbsp;Stephanie J. Brown ,&nbsp;Yvonne Clark","doi":"10.1016/j.fnhli.2025.100062","DOIUrl":"10.1016/j.fnhli.2025.100062","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to develop the first Aboriginal-led co-designed tool to map Australian Aboriginal children’s social and emotional wellbeing (SEWB) based on holistic definitions of wellbeing that have been discussed, supported and refined by Aboriginal and Torres Strait Islander peoples over the last 30 years.</div></div><div><h3>Methods</h3><div>Development of the Aboriginal Children’s SEWB Tool was embedded in wave 2 follow-up of an existing cohort of families: the Aboriginal Families Study (AFS). Items from a questionnaire completed by mothers/caregivers of the study children (aged 5–8 years) were selected to map the seven domains of the SEWB framework. The process was Aboriginal-led by the first author, the AFS research team and Aboriginal Governance Group. Psychometric testing and revision included assessment of the structure, testing of the internal consistency of domains, and criterion validity against the Strengths and Difficulties Questionnaire (SDQ).</div></div><div><h3>Main findings</h3><div>The Aboriginal Children’s SEWB Tool (parent/caregiver report) comprises 80 items grouped into 29 indicators across six domains: Body; Mind and emotion; Family and kinship; Community; Culture; and Country, spirit and spirituality. Criterion validity was supported: children with high scores on the SEWB Tool had seven times higher odds of positive emotional wellbeing and four times the odds of high mental health competence, as measured with the SDQ, compared with children with low scores (Adj. OR 7.7, 95% CI 2.5 – 23.9 and Adj. OR 3.9, 95% CI 1.4 – 10.2, respectively). Fewer items were available on connection to Country, spirit, spirituality and ancestors; further refinement in these areas will be of benefit.</div></div><div><h3>Principal conclusion</h3><div>The Aboriginal Children’s SEWB Tool was developed in response to a lack of measures recognising Aboriginal and Torres Strait Islander peoples’ conceptualisations of child social and emotional wellbeing. The new tool provides a holistic picture of SEWB experienced by Aboriginal children, with the capacity to map strengths, gaps and areas for healing across body, mind and emotion, family and kinship, community, culture and Country, spirit and spirituality. Use of the tool would support health and social practitioners working with individual children and families, within schools as well as in research settings. Work is needed to further enhance the tool.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100062"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A First Nations-led community survey of early COVID-19 pandemic experiences in Victoria, Australia","authors":"Katarzyna Wojcik ,&nbsp;Jane Goller ,&nbsp;Joanne Luke ,&nbsp;Lina Gubhaju ,&nbsp;Richard Chenhall ,&nbsp;Graham Gee ,&nbsp;Ngaree Blow ,&nbsp;Lisa Thorpe ,&nbsp;Paul Stewart ,&nbsp;Alister Thorpe","doi":"10.1016/j.fnhli.2025.100060","DOIUrl":"10.1016/j.fnhli.2025.100060","url":null,"abstract":"<div><h3>Purpose</h3><div>During 2020, state and federal government-mandated restrictions and extended lockdowns were implemented in Australia because of the increasing presence of coronavirus disease 2019 (COVID-19). In response to COVID-19 and restrictions, First Nations communities and organisations across Australia developed resources and strategies for support. The state of Victoria experienced the lengthiest lockdowns in Australia. This study aimed to describe the health and sociocultural experiences of First Nations peoples in the Australian state of Victoria during these restrictions.</div></div><div><h3>Methods</h3><div>The Measuring Indigenous Communities’ Response, Resilience and Recovery online survey was developed and implemented by an Indigenous leadership group. This cross-sectional study focused on First Nations communities’ experiences of the pandemic. Descriptive and thematic qualitative analyses were conducted to explore outcomes related to health and social experiences, and cultural and community connectedness.</div></div><div><h3>Main findings</h3><div>A total of 67 people responded between November 2020 and January 2021; 49 (73.1%) were female, with a median age of 47 years, and 54 (81.8%) resided in metropolitan Melbourne. Many respondents (47.5%) reported difficulty accessing general healthcare, mental health and education. First Nations organisations and family members were the primary source of additional support during 2020. Changes in health behaviours – such as alcohol consumption, tobacco use and physical activity – after restrictions were variable. For community connection, respondents reported decreases in seeing family and attending cultural events; however, they reported an increase in the use of technology to connect with community.</div></div><div><h3>Principal conclusions</h3><div>This study provides insights into the experiences of First Nations peoples in Victoria during the 2020 COVID-19 pandemic response, and the types of support and resources accessed. The importance of community connectedness during the COVID-19 pandemic and First Nations-led responses to support community to promote better health outcomes was highlighted in this study.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100060"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When reconciliation overshadows rights: The Métis’ continued fight for health data and recognition","authors":"Alexandra Nychuk (Métis - Manitoba Métis Federation) ,&nbsp;Kiera Kowalski (Métis - Manitoba Métis Federation) ,&nbsp;Chelsea Gabel (Métis - Manitoba Métis Federation) ,&nbsp;Robert Henry (Métis - Métis Nation Saskatchewan)","doi":"10.1016/j.fnhli.2025.100068","DOIUrl":"10.1016/j.fnhli.2025.100068","url":null,"abstract":"<div><div>In 2021, the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) Act received royal assent in Canada, further affirming inherent rights for Indigenous peoples (First Nations, Inuit and Métis). Despite this and a constitutional recognition of Aboriginal rights in 1982, the Métis have yet to have their right to health recognised. The prioritisation of pan-Indigenous approaches to addressing inequities in Canada neglects to recognise the collective rights (exercised through a governing body, nation, tribal community, etc.) that diversifies Indigenous rights from other human rights. Métis critically need accurate health data that are conducted using distinctions-based approaches, as they remain stuck in data dependency. However, a considerable barrier to Métis data collection is that Indigenous health research funding in Canada predominantly favours pan-Indigenous approaches, rendering the Métis insignificant in their fight for health recognition.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring best practices that integrate environmental health and primary healthcare in Indigenous populations: A scoping review","authors":"Jayden Wells ,&nbsp;Veronica Matthews ,&nbsp;Amal Chakraborty","doi":"10.1016/j.fnhli.2025.100071","DOIUrl":"10.1016/j.fnhli.2025.100071","url":null,"abstract":"<div><h3>Purpose</h3><div>Country and the environment are essential components of Aboriginal and Torres Strait Islander wellbeing. Colonisation disrupted these essential connections, damaging important reciprocal beneficial relationships that kept Country and community well. As a result, Indigenous populations exhibit poorer health outcomes compared with non-Indigenous Australians, with the life expectancy of Indigenous Australians being 74 years compared with 84 years in the general population. It is reported that 20 to 30 per cent of Indigenous disease burden can be attributed to environmental factors; however, historically, there has been little coordination between the environmental and primary healthcare sectors in Australia. The National Aboriginal Community Controlled Health Organisation (NACCHO) has called for increased collaboration between environmental initiatives and primary healthcare to address various health disparities present within Indigenous Australians. This scoping review aimed to identify and analyse best practices that integrate environmental health initiatives and primary healthcare within Indigenous populations.</div></div><div><h3>Methods</h3><div>Standard scoping review methodology was employed in accordance with PRISMA-ScR Joannah Briggs Institute guidelines. Databases that were searched included CINAHL, Scopus, MEDLINE and Embase, as well as grey literature, between 2004–24. Inclusion criteria focused on studies involving international Indigenous populations, environmental health factors and primary healthcare integration, with two primary reviewers and a third for resolving conflicts.</div></div><div><h3>Main findings</h3><div>A total of 32 papers, primarily from Australia, were included in the final review. Regarding environmental determinants, there was a strong focus on housing condition, water quality and Indigenous land management. Various integrated programs demonstrated significant health improvements, such as reduced prevalence of infectious disease, enhanced cardiovascular health and better mental health outcomes. The concept of Indigenous 'caring for Country' emerged as a central theme, demonstrating the benefits of a unified approach to healthcare.</div></div><div><h3>Principal conclusions</h3><div>These findings demonstrate the value of implementing connections between environmental and primary healthcare services in improving Indigenous health. Factors leading to program success included community participation, Indigenous leadership and targeted, place-based interventions. However, there is a general lack of published evidence that sustainably integrates both environmental health and primary care. The limited number of examples demonstrated positive health outcomes, indicating the need for more community-led and Country-centred initiatives within primary care.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100071"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Peoples’ cultural medicines: A review of Australian health policies using an Indigenous critical discourse analysis approach","authors":"Alana Gall (Pakana, Truwulway) ,&nbsp;Mike Stephens ,&nbsp;Zyana Gall (Pakana, Truwulway) ,&nbsp;Danielle Armour (Kamilaroi) ,&nbsp;Nicole Hewlett (Melukerdee, Palawa) ,&nbsp;Michelle Kennedy (Wiradjuri) ,&nbsp;Theresa Sainty (Pakana, Truwulway) ,&nbsp;Allyra Hulme (Wiradjuri) ,&nbsp;Jon Wardle ,&nbsp;Megan Campbell ,&nbsp;Andrew T. Gall (Pakana, Truwulway) ,&nbsp;Amie Furlong ,&nbsp;Kate Anderson","doi":"10.1016/j.fnhli.2025.100046","DOIUrl":"10.1016/j.fnhli.2025.100046","url":null,"abstract":"<div><h3>Purpose</h3><div>First Peoples in Australia tend to have shared holistic understandings of health and wellbeing that emphasise strong interconnections among family, community, culture and Country. Central to this holistic health framework is First Peoples’ cultural medicines, which most First Peoples use or want to use, and have been used for millennia to heal the bodies, minds and spirits of First Peoples. This review aimed to explore and document the inclusion and representation of cultural medicines across national level policies and practice guidelines for health professionals. These policies intend to support effective and appropriate healthcare for all Australians, including First Peoples.</div></div><div><h3>Methods</h3><div>Australian national health policies that guide the practice of Australian Health Practitioner Regulation Agency registered health professionals and Aboriginal and Torres Strait Islander health workers/Indigenous liaison officers were systematically reviewed to explore their representation of cultural medicines in these policies. The review was informed by Indigenous critical discourse analysis that was modified to suit the review context. National level health policies from March to June 2023 were mapped and 52 policies eligible for inclusion were identified. Policies were downloaded and imported into NVivo for analysis. NVivo text search queries were conducted and nine policies were found to include any content about cultural medicines.</div></div><div><h3>Main findings</h3><div>Three overarching themes were found: 1) Absence of national leadership; 2) Disproportionate onus placed on Aboriginal and/or Torres Strait Islander health practitioners; and 3) Lack of detail and actionable directives. There was a distinct lack of representation of cultural medicines in national health policies, with most of these policies not providing any clear guidance for health professionals. The responsibility was too heavily placed on First Peoples health professionals to lead the healthcare related to cultural medicines.</div></div><div><h3>Principal conclusions</h3><div>The significant lack of national leadership and actionable directives around cultural medicines is concerning. To uphold cultural safety and the rights of Australia’s First Peoples, it is critical to have clear policy guidance, resources and training that support all Australian health professionals to engage with cultural medicines and see it as part of their responsibility.</div></div>","PeriodicalId":100532,"journal":{"name":"First Nations Health and Wellbeing - The Lowitja Journal","volume":"3 ","pages":"Article 100046"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}