在原住民和托雷斯海峡岛民社区结束风湿性心脏病:澳大利亚预防计划的系统回顾

Yumeng Cai , Lori J. Delaney , Debby Lynch , Jacqueline Cunninghame , Mari Takashima , Amanda Ullman , Maree Toombs , Antonella Martin , Kate Thompson , Karina Maxwell , Jane Moore , Catherine Kilgour , Lorelle Holland
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引用次数: 0

摘要

目的:澳大利亚是世界上急性风湿热(ARF)和风湿性心脏病(RHD)发病率最高的国家之一,土著和托雷斯海峡岛民社区的疾病负担过重。本系统综述旨在探讨预防项目的有效性和文化响应性,以预防、减少和控制RHD,提高生活质量,并优先考虑社区参与和赋权。方法综合检索PubMed、Embase和CINAHL三个数据库,以及来自澳大利亚原住民网站和谷歌Scholar的灰色文献,进行系统评价。如果文章评估了预防方案,针对ARF/RHD,并以澳大利亚土著和托雷斯海峡岛民社区为中心,则符合纳入标准。数据由三位审稿人提取,并对结果进行描述性分析。通过混合方法评估工具和原住民和托雷斯海峡岛民质量评估工具来评估研究质量。主要发现:包括6篇同行评议的文章。预防方案在减少ARF和RHD方面的有效性和文化响应性各不相同。总体而言,通过混合方法评估工具确定的总体方法质量得分高于通过土著和托雷斯海峡岛民质量评估工具测量的文化反应性。与土著和托雷斯海峡岛民社区进行的研究涉及改进筛查战略以确定ARF的方法、认识到RHD坚持使用青霉素预防、社区主导的教育和培训、环境卫生和以社区为中心的传统语言,以传达符合文化的卫生信息。为减少ARF和RHD的发生率,迫切需要进一步的研究来提供有效和符合文化的预防方案。以土著人主导和基于社区的预防方案为中心进行的研究为消除ARF和RHD提供了希望,这些方案重视自决、社区代理和自治,以促进土著人和托雷斯海峡岛民的整体健康和福祉。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ending rheumatic heart disease in Aboriginal and Torres Strait Islander communities: A systematic review of prevention programs in Australia

Purpose

Australia has one of the highest incidences of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in the world, with a disproportionate disease burden on Aboriginal and Torres Strait Islander communities. This systematic review aimed to explore the effectiveness and cultural responsiveness of prevention programs to prevent, reduce and control RHD, to improve quality of life, and prioritise community engagement and empowerment.

Methods

A systematic review was conducted involving a comprehensive search of three databases (PubMed, Embase and CINAHL) and grey literature from Australian Indigenous websites and Google Scholar. Articles met inclusion criteria if they evaluated prevention programs, targeted ARF/RHD and centred Aboriginal and Torres Strait Islander communities in Australia. Data were extracted by three reviewers, and results were descriptively analysed. Study quality was appraised via the Mixed Methods Appraisal Tool and the Aboriginal and Torres Strait Islander Quality Appraisal Tool.

Main findings

Eleven peer reviewed articles were included. Prevention programs varied in their effectiveness and cultural responsiveness to reduce ARF and RHD. Overall, the studies scored higher for generalised methodological quality determined by the Mixed Methods Appraisal Tool than the measurement of cultural responsiveness via the Aboriginal and Torres Strait Islander Quality Appraisal Tool. Research engagement with Aboriginal and Torres Strait Islander communities addressed ways to improve screening strategies to identify ARF, awareness of RHD adherence to penicillin prophylaxis, community-led education and training, environmental health and community-centred traditional language to convey culturally responsive health messaging.

Principal conclusions

Further research is urgently needed in the provision of effective and culturally responsive prevention programs to reduce the incidence of ARF and RHD. Studies that centre Indigenous-led and community-based prevention programs that value self-determination, community agency and autonomy to advance holistic health and wellbeing for Aboriginal and Torres Strait Islander peoples offer promise in the elimination of ARF and RHD.
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