NACCHO Aboriginal Health supports our First Nations Media @FNMediaAust #OurMediaMatters Campaign : Download nine calls for action that the Government needs to address

We are asking Governments to be part of growing and sustaining our sector for the benefit of First Nations peoples as well as developing greater understanding of our cultures for the benefit of non- Indigenous Australia

Our national network includes more than 40 organisations that service 235 broadcast locations. Collectively those radio services reach nearly 50% of Aboriginal and Torres Strait Islander people across the country with audiences of around 320,000 listeners each week

We are producing and broadcasting content in over twenty languages. We’ve been making media through film, television, radio and print for more than four decades and in recent years diversified to on-line platforms.

People watch and listen and interact because our media tell positive stories about First Nations people relevant to their community and lives, and in many places, it’s in their first language.

Our media engages our audiences in a two-way dialogue that is both culturally appropriate and relevant.

Our media is an essential service, particularly in the many areas across Australia where it is the only means of receiving emergency information and health messages, including local languages.

Our media saves lives in the immediate sense as a primary source of information, but also through the stories we tell and the impact those stories have on our people’s social and emotional wellbeing.

That’s why our media has impact and that’s why we want Governments to recognise that our media matters.

First Nations Media Australia chair Dot West

#OurMediaMatters was the message First Nations media organisations from around the country  took directly to politicians and policy makers in Canberra this week from Monday 20 August .

FNMA’s goals in calling for action are to close the gap on disadvantage, to inform, connect and empower communities, to provide meaningful jobs, skills and business opportunities, and to provide our children with opportunities, a strong sense of identity, inclusion and pride in their languages and culture.

Download the full call to action

Calls-For-Action-2018-Consolidated-CFA-Documents

Peak body First Nations Media Australia (FNMA) showcased the work of member organisations and how First Nations media services play a crucial role in increasing community cohesion, building community resilience and creating meaningful employment and economic opportunity

Picture below 2017 Conference

The Festival theme was Lutjurringkulala Nintiringama Ngapartji Ngapartji meaning ‘come together to learn and share’.

Over 100 delegates travelled the long red desert highway to be welcomed to Country, culture, big night skies and Tjukurrpa by Irrunytju traditional owners and community leaders. The opening ceremony featured a Turlku (dance) performance of the Minyma Kutjara (Two Sisters) story that passes Irrunytju community. The week-long event affirmed the remote Aboriginal and Torres Strait Islander media industry as a powerful and connected voice for generations to come.

Broadcasters

Imparja Television

Indigenous Community Television (ICTV)

National Indigenous Radio Service (NIRS)

National Indigenous Television (NITV)

Broadband for the Bush Alliance

Aboriginal Medical Services Alliance NT

Australian Communications Consumer Action Network (ACCAN)

Australian Smart Communities Association

Central Australian Aboriginal Media Association

Central Desert Shire Council

Central Land Council (CLC)

Centre for Appropriate Technology (CAT)

Centre for Remote Health (CRH)

Desert Knowledge Australia (DKA)

Ethos Global Foundation

Frontier Services

Indigenous Remote Communications Association

Infoxchange

Mid West Development Commission

National Centre of Indigenous Excellence

National Rural Health Alliance

Ninti One

Regional Development Australia, Northern Territory

Remote Area Planning and Development (RAPAD)

Swinburne Institute for Social Research

TelSoc

FNMA has identified nine calls for action to Government that address four key aims

  • To increase jobs and skills
  • To improve the sector’s capacity and sustainability
  • To enhance social inclusion, and
  • To preserve culture and language.

Some of the calls for action are budget neutral and simply ask for policy amendments to recognise First Nations broadcasters as a separate license category under the Broadcasting Services Act.

  1. Broadcasting Act Reform for First Nations Broadcasting. Download
  2. Increase in Operational and Employment Funding. Download
  3. Live and Local Radio Expansion Program. Download
  4. Strengthening of First Nations News Services. Download
  5. Expanding Training and Career Pathway Programs. Download
  6. Upgrading Infrastructure and Digital Networks. Download
  7. Recognising First Nations Broadcasters as the Preferred Channel for Government Messaging. Download
  8. Preserving First Nations Media Archives. Download
  9. Establishing an Annual Content Production Fund. Download

Other calls for action would require a funding commitment, for example to underpin First Nations media capacity to act as training and employment hubs.

NACCHO Aboriginal Health #ClosetheGap TV : Minister @KenWyattMP announces New $3.4 million Digital Aboriginal Health Television @TonicHealth_AU Network to Help in Closing The Gap

We are aiming to start the rollout in October, with the Aboriginal Health TV Network expected to reach up to 1.2 million people each month in hundreds of community controlled primary health care waiting rooms across the nation

The scope of this network is exciting, with important health and wellbeing stories, plus local production input to ensure the broadcasts are relevant and engaging for their audiences.

Through an entertaining and compelling format, health messages will be delivered on issues such as smoking, eye and ear checks, skin conditions, diet, immunisation, sexual health, diabetes and drug and alcohol treatment services.

Indigenous Health Minister Ken Wyatt AM

A comprehensive new digital television network will be rolled out across hundreds of health centres, as the Turnbull Government works with First Nations communities to Close the Gap and achieve health equality.

Over the next three years $3.4 million has been committed to develop the Aboriginal Health TV network, which will deliver health and wellbeing messages through Aboriginal Community Controlled Health Services.

Content will be developed by the Aboriginal Health TV Network in partnership with local Aboriginal health services, to ensure it is culturally appropriate and relevant. The Aboriginal Health TV Network will also use mobile solutions and social media sites such as Facebook, Instagram and YouTube to expand the platform’s reach and promote engagement.

“This is a unique opportunity to connect with First Nations audiences at the point of care” Minister Wyatt said. The Aboriginal Health TV Network will be developed by reputable health communications company, Tonic Health Media, as a not-for-profit enterprise, with oversight from its Indigenous Advisory Board.

Board members are respected members of the Aboriginal and Torres Strait Islander health community, including Dr Mark Wenitong from Apunipima Cape York Health Council, Donna Ah Chee from the Central Australian Aboriginal Congress, Adrian Carson from the Institute of Urban Indigenous Health, Professor Sandra Eades from the University of Melbourne and Associate Professor Dr Christopher Lawrence from the University of Technology Sydney.

Info will also be shared on NACCHO TV and our NACCHO social media platforms

“The new Aboriginal Health TV Network will be installed in Aboriginal health services free of charge and it is envisaged it will be self-sufficient within three years,” said Minister Wyatt. “Importantly, programming from the Network will also be available for transmission on Tonic Health Media’s existing platform which broadcasts in mainstream health services.”

“That means the health messaging will also reach the 50 per cent of First Nations people who use non-Aboriginal health services.”

The Aboriginal Health TV Network will also build partnerships with broadcasters and Aboriginal producers across Australia who specialise in producing Indigenous television content

. The Aboriginal Health TV Network is part of the Turnbull Government’s extensive work with First Nations people, to improve health and wellbeing.

The Government announced $3.9 billion over four years in health services funding for Aboriginal and Torres Strait Islander people in the 2018-19 Budget.

NACCHO Aboriginal Health #ehealth #MyHealthRecord : Download @CHFofAustralia @georgeinstitute Report : Digital health to transform Australia’s health system and save lives

“The time is now ripe to leverage this maturing digital health capacity in ways that are meaningful to both consumers and providers. If done well, it has potential to be transformative for Australia’s health system bringing about rapid enhancements in quality, safety, accessibility and efficiency,”

Digital disruption is not coming in health care – it is already here. For too long health has been lagging behind other sectors.

For Australia to embrace digital health and benefit from its huge potential, we need national leadership.

We need to invest in implementation and change management to avoid the risks and pitfalls that can accompany the roll-out of such powerful technology into a complex and sensitive area like health care “

CEO of the Consumers Health Forum, Leanne Wells

Download full report here

GDigital_Report

Australia now has many of the building blocks in place to roll out a digitally enabled health system that could transform care services, an expert report has found.

The report, developed after an expert roundtable initiated by the Consumers Health Forum and The George Institute for Global Health, says “the time is now ripe” to support the expansion of digital health technology in vital areas including chronic care and residential aged care.

The report is based on discussions held by around 40 consumers, clinicians, academics, government and industry supported by the Australian Digital Health Agency.

Roundtable attendees considered four sectors — chronic care, residential aged care, emergency care and end of life care — in terms of what is wanted from digital health, the current state of digital health in that sector and how to meet goals for the future.

The report says major progress is being made with My Health Record, e-prescriptions, patient registries, shared care portals, state-based digital health strategies and linked hospital patient information systems.

Professor David Peiris, Director of Health Systems Science at The George Institute, said emerging digital health strategies had the potential to transform Australia’s health system for both health care providers and consumers.

“Our report sets out clear recommendations on what is needed to enable people to be much more in control of their own health needs and to make informed choices about the care they choose – from urgent life-saving situations through to respecting their wishes at the end their life.

“We also want to ensure that every health professional in Australia can take full advantage of the digital health eco-system to improve people’s healthcare experience and provide care that can be co-ordinated across the system. Many Australians are tired of having to constantly repeat their story to multiple care providers and it’s vital that we tap into digital technology to ensure we deliver a more person-centred, safer and sustainable healthcare system.

“Australia has made a great start in its uptake of digital health technology and we have identified practical steps in several areas that could be rolled out rapidly. The challenge now is to ensure they are adopted.”

 

The recommendations identified by the roundtable included:

In chronic care: To trial virtual care teams to support patients with high care needs; and trial a “Patients Like Me” platform to enable patients with chronic and complex care needs to safely connect and share experiences with one another.

In residential aged care: Ensure that residents’ health and social services information is available in a single location, on a platform easily accessible by consumers and providers anywhere, anytime and on any device. Collate and publicise data that allows patients, their carers and future consumers to compare residential care facilities based on health outcomes and patient experiences.

In emergency care: Develop digital health technologies that leverage My Health Record data to be rapidly accessible to paramedics and other emergency providers; develop a text/image message system to support improved communication between emergency care and other medical teams and assist with referrals to other health care providers for post-discharge care.

In end of life care: Develop and promote existing professional and consumer portals that provider information on care options, medical services and pathways for those nearing end of life; and engage in targeted social media campaigns to encourage consumers and medical professionals to normalise conversations about death

Dr Google will see you now ! NACCHO Aboriginal Health Alert @AMAPresident says Doctor #Google no substitute for a visit to your trusted ACCHO / Family GP.

 ” We live in a digital generation. People use their smartphones and the internet for absolutely everything in life, so it’s to be expected that they’ll use it in regard to their health, and we know that health is one of the main reasons that people access search engines like Google.

One of the reasons doctors do recoil in horror is that some of the quality of the information on the internet leaves a lot to be desired.

So when a patient presents to their GP or another specialist and says they’ve done their own research on vaccinations and they’ve spent 20 minutes and that’s meant to overcome hundreds, thousands of hours of research into different  ” vaccines, that’s the kind of thing that makes doctors upset.

But we need to be clever enough and sensitive enough to listen to people, and often they’ve done part of the work for us.

Dr Michael Gannon President AMA responding to a question about Dr Google from Lisa Barnes  6PR Breakfast Perth 3 January 2018

Will patients stop going to the GP?

 “According to Google, one in 20 Google searches are health-related. Google’s new health cards will include facts vetted by a team of “medical doctors”, the company says, and adds:

“Each fact has been checked by a panel of at least ten medical doctors at Google and the Mayo Clinic for accuracy.”

Google’s Isobel Solaqua also encouraged patients to still seek professional medical attention.

What we present is intended for informational purposes only — and you should always consult a healthcare professional if you have a medical concern.”

Google’s new function might be handy for giving patients more accurate information – rather than having people wind up on dusty message boards and forums with questionable advice.”

Source Dr Google will see you now :

 ” At the first sign of a headache (“brain tumour?”), aching joint (“dengue?”) or a rash (“measles?”) do you find yourself looking to Dr Google? If so, then there’s a chance that your real malaise warrants another moniker: cyberchondria.

With one in 20 Google searches a quest for health information, many of us are likely familiar with the anxiety that goes with compulsively searching online for real (or imagined) health issues.

But is all this googling actually paying off in terms of our health and wellbeing?

For some time, researchers have pointed out that our ability to find out almost anything health-related through a quick online search has its downsides.”

NACCHO would suggest you use Dr Google and download the NACCHO APP that can help you find one of the 302 ACCHO Clinics throughout Australia ( and make a booking with one of our real ACCHO Doctors)  

Download the NACCHO App HERE

And here is why

 ” Well, Dr Google should never, and will never, be a surrogate for a face to face consultation.

There’s a lot of skill in medical practice – sometimes it’s unseen to patients – but there is a skill in taking a history, performing an examination, working out which tests are and aren’t indicated, thinking about how you’re going to interpret those tests and what your follow-up plan is.”

Dr Michael Gannon on why you should see a real Doctor

Full Transcript of Interview

MICHAEL GANNON:   I think there’d be plenty of patients who would have positive experiences, and there’d be plenty of patients that are led down the garden path. I think that if you put into a search engine the basic symptoms, in my experience most patients end up diagnosing themselves with either leukaemia or a brain tumour. But if you ask for something very specific, there’s some very credible and very useful health information that gives patients an idea how to proceed.

GEOF PARRY:   Michael, I think the AMA has been concerned about Dr Google in this sense, that they’ve been presenting to doctors and some doctors have been getting a bit upset about it, and you’re sort of saying, isn’t it, that it’s a bit of a fact of life now and you have to work with it?

MICHAEL GANNON:   I think you’re exactly right, Geof. We live in a digital generation……….

See opening extract

But we need to be clever enough and sensitive enough to listen to people, and often they’ve done part of the work for us.

LISA BARNES:   You’re right though, it is about using a little bit of common sense and being a bit specific with what you’re searching for, isn’t it? Because I know I’ve used Dr Google, and yeah, I seem to come up with about 17 serious diseases that I’ve got. But if you narrow it down, you can use that information for good, can’t you?

MICHAEL GANNON:   You can. I mean, some of the State Health Departments have very high-quality information that’s available. I would encourage people to have a look at where the information’s coming from.

So, if the search engine directs them to a website of one of the learned Colleges or a State or Territory Health Department, one of the august bodies in the English-speaking world like Britain or the United States, you might get valuable information.

I use Wikipedia to look up genetic conditions and rare syndromes all the time and, although I have concerns about how often some of that information’s curated, overall it’s extremely good. It’s when people start googling individual symptoms they usually get led down the garden path.

GEOF PARRY:   Michael, I’m wondering whether it’s any different using Dr Google to, say, the sorts of things that the medical profession has had to counter in the past.

So – and I’m going to get criticised for this – but, say, iridology, where people have used iridology to sort of find out what they might be suffering from, or having their auras, their colours read, those sorts of things which, in some schools of thought, these are just quackery.

MICHAEL GANNON:   Yeah, well, you’re right, Geof. We worry a lot about the quality of the health information that’s out there.

Where this story started- I did an interview with a journalist at the Courier Mail in Brisbane, and it was based on a directive from the NHS in Britain, the NHS asking patients to try Google first. Now, that represents a failing health system.

We don’t have that problem in Australia. We hear individual stories, but overall the statistics show that it’s not hard to get an appointment to see a GP, and let’s not forget that 85 per cent of GP services are bulk billed – it costs nothing.

It represents, in a world where it’s increasingly difficult to find value for money for people on fixed wages, a visit to your GP represents value for money like no other I know in the whole community.

LISA BARNES:   And certainly, Michael, obviously the advice would be double check or get it confirmed by a doctor, don’t just take Dr Google at face value.

MICHAEL GANNON:   Well that’s exactly right, and people should never ignore danger symptoms, and individual human beings, the parents, guardians of young children, people caring for elderly relatives, et cetera, should never hesitate to seek medical attention.

The reality is that GPs and doctors in Emergency Departments do see sometimes odd and not particularly high value presentations, but we would never want a situation where someone second-guessed themselves and didn’t seek health care.

GEOF PARRY:   Yeah, is there a couple of risks – like quite serious risks – here? I mean, you can put your health at risk if you put your trust in something like Dr Google and they get it wrong, or are you just completely wasting time and wasting people’s time by going down that path?

MICHAEL GANNON:   Well, Dr Google should never, and will never, be a surrogate for a face to face consultation.

There’s a lot of skill in medical practice – sometimes it’s unseen to patients – but there is a skill in taking a history, performing an examination, working out which tests are and aren’t indicated, thinking about how you’re going to interpret those tests and what your follow-up plan is.

Medical care’s a lot more complicated than sometimes doctors get given credit for. Looking something up on a search engine can be a useful adjunct. We do need to do better with health literacy in our community. I’d love to see more biological sciences taught in high school, but for now it’s a useful tool that people can use to either give themselves reassurance or to make it clear they do need to see a doctor.

LISA BARNES:   Michael, we appreciate your time. Thank you.

MICHAEL GANNON:   Pleasure. Happy New Year to both of you.

LISA BARNES:   And to you. That’s Dr Michael Gannon, the AMA President

NACCHO Aboriginal Health : Download The @RACGP Five steps towards excellent Aboriginal and Torres Strait Islander healthcare

 

 ” The RACGP’s Five steps towards excellent Aboriginal and Torres Strait Islander healthcare has been developed to provide a clear and concise summary of the programs and funding options available to support better care for Aboriginal and Torres Strait Islander patients “

Download 1Five-steps-guide

Download 2. Five-steps-summary-sheet

RACGP Aboriginal and Torres Strait Islander Health produced these resources to help give busy GPs and practice teams practical advice that builds on a foundation of cultural awareness.

The five steps:

1. Prepare and register for the Practice Incentives Program (PIP)
Register for the Indigenous Health PIP Incentive, staff complete accredited cultural awareness training, create a welcoming practice environment.

2. Identify your Aboriginal and Torres Strait Islander patients
Asking whether someone identifies as Aboriginal and/or Torres Strait Islander can cause discomfort in practice staff; however, evidence shows that patients are comfortable when asked if the reasons can be explained.

If patients choose to identify as Aboriginal and/or Torres Strait Islander, they will do so when prompted.

3. Perform a health assessment
Performing a Medicare health assessment for Aboriginal and Torres Strait Islander people (MBS item 715) opens access to an additional five allied health visits.

Conducting a health assessment with a patient is an opportunity to build rapport and trust, and to develop an ongoing relationship. In addition to identifying physical health problems, discussing psychological and social functions is an effective approach to two-way communication with Aboriginal and Torres Strait Islander patients.

4. Register patients with, or at risk of, a chronic disease for the Closing the Gap (CTG) Pharmaceutical Benefits Scheme (PBS) co-payment
Once a practice is registered for the Indigenous PIP (Step 1), it is able to register patients for the CTG PBS co-payment.

5. Use appropriate clinical guidelines and programs from the RACGP, Medicare and Primary Health Networks to enhance access and quality of care
The National Aboriginal Community Controlled Health Organisation (NACCHO)/RACGP National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (the National guide) outlines the activities that are effective for preventive health.

More information is also available in the Australian Indigenous Health InfoNet Indigenous Health service eLearning program.

Other resources in the Five steps towards excellent Aboriginal and Torres Strait Islander healthcare include a Five steps guide, which features detailed information to support GPs and practice teams to access programs and funding options; a quick reference guide to MBS items, policy and programs; and a Five steps visual poster, which is a condensed version of the five steps that can be displayed in a practice.

The RACGP will also be developing supplementary resources throughout 2018 to support GPs to implement the five steps in a way that achieves the best outcomes for practices and Aboriginal and Torres Strait Islander patients.

First published in newsGP. Reproduced with permission of the RACGP.
 

 


THE AUTHOR: Mr Paul Hayes Paul is an experienced healthcare journalist and the editor of newsGP.

NACCHO Aboriginal #MentalHealthDay : Australia’s new digital #mentalhealth gateway now live

 ” Today we are launching our new digital mental health gateway – Head to Health.

Head to Health is an essential tool for the one in five working age Australians who will experience a mental illness each year.

The website helps people take control of their mental health in a way they are most comfortable with and can complement face-to-face therapies.

Evidence shows that for many people, digital interventions can be as effective as face-to-face services.

Head to Health provides a one-stop shop for services and resources delivered by some of Australia’s most trusted mental health service providers.

They include free or low-cost apps, online support communities, online courses and phone services.

Head to Health provides a place where people can access support and information before they reach crisis.

The Hon. Greg Hunt MP Minister for Health launching www.headtohealth.gov.au

See full press release from Minister Part 3 below

 ” For Aboriginal and Torres Strait Islander peoples, the strength of personal identity is often connected to culture, country and family.

Like all of us, however, you can have problems with everyday things like money, jobs and housing that can impact your social and emotional wellbeing. On top of that, you might have to deal with racism, discrimination, bullying, gender-phobia, and social inequality ”

READ MORE ON THIS TOPIC HERE

 ” Aboriginal and Torres Strait Islander health and wellbeing combines mental, physical, cultural, and spiritual health of not only the individual, but the whole community. For this reason, the term “social and emotional wellbeing” is generally preferred and better understood than terms like “mental health” and “mental illness”.

Addressing social and emotional wellbeing for Aboriginal and Torres Strait Islander peoples requires the recognition of human rights, the strength of family, and the recognition of cultural diversity – including language, kinship, traditional lifestyles, and geographical locations (urban, rural, and remote).”

READ MORE ON THIS TOPIC HERE  

Part 1 NACCHO BACKGROUND

Read over 160 NACCHO Aboriginal Mental Health Articles published over 5 yrs

Read over 115 NACCHO Suicide Prevention Articles published over 5 yrs Including

NACCHO Aboriginal Health : #ATSISPEP report and the hope of a new era in Indigenous suicide prevention

Our NACCHO CEO Pat Turner as a contributor to the report attended the launch pictured here with Senator Patrick Dodson and co-author Prof. Pat Dudgeon

After almost two years of work, ATSISPEP released a final report in Canberra on the 10th of November 2016.

Download the final #ATSISPEP report here

atispep-report-final-web-pdf-nov-10

Part 2 Mental Health Australia campaign

We need to see tackling stigma around mental health as a way to improve the health of the nation, improve our productivity, improve our community engagement, and improve our quality of life.”

“Yes we’ve come a long way to challenge and change perceptions, and paved the way for many to tell their story, but there is still great stigma associated with mental illness.”

“This year, my #mentalhealthpromise is to challenge Australia to look at mental health through a different light. Let’s look at the positives we can achieve as a community by reducing stigma and changing our approach to improving someone’s health.”

Mental Health Australia CEO Mr Frank Quinlan

Today World Mental Health Day – Tuesday 10 October – and Mental Health Australia is calling on the nation to further reduce stigma and promise to see mental health in a positive light.

‘Do you see what I see?’ challenges perceptions on mental illness aiming to reduce stigma.

‘Do you see what I see?’ promotes a positive approach to tackling an issue that affects one in five Australians.

‘Do you see what I see?’ aims to put a new light on the conversation… from dark to bright. Incorporating the successful #MentalHealthPromise initiative, which last year saw both the

Prime Minister and Opposition Leader make a mental health promise to the nation, ‘Do you see what I see?’ will also feature a series of photos from across Australia, shedding light and colour on an issue which is still cloaked in darkness.

“We’ve all seen it before… The stock black and white photo of someone sitting with their head in their hands signifying mental illness. That’s stigma… and stigma is still the number one barrier to people seeking help. Help that can prevent and treat,” said Mental Health Australia CEO Mr Frank Quinlan.

“We have to see things differently, and see the positive outcomes of tackling this issue if we are to see real benefits and reductions in the rate of mental illness affecting the nation.”

“We need to see mental health, and mental wealth through our own eyes, through the eyes of a family member or close friend and through the eyes of those in our community who don’t have that support around them.”

‘What will your #MentalHealthPromise be?

Making and sharing a mental health promise is easy and takes just a few minutes at www.1010.org.au

Part 3 The Hon. Greg Hunt MP Minister for Health press release Continued

Australia’s new digital mental health gateway now live

As part of our over $4 billion annual investment in mental health, the Turnbull Government is today launching our new digital mental health gateway – Head to Health.

Head to Health provides a place where people can access support and information before they reach crisis.

And it will continue to grow with additional services, a telephone support service to support website users, and further support for health professionals to meet the needs of their patients.

I encourage not only people seeking help and support, but anyone wanting to learn more on how to maintain good mental health wellbeing, to visit the website at: www.headtohealth.gov.au.

The Turnbull Government supports the need for a long term shift in mental health care towards early intervention, and the Head to Health gateway will help with this.

We have recently announced $43 million in funding for national suicide prevention leadership and support activity to organisations across Australia such as R U OK?, Suicide Prevention Australia and Mindframe.

This year we are investing $92.6 million in the headspace program to improve access for young people aged 12–25 years who have, or are at risk of, mental illness.

In addition, we have provided $52.6 million to beyondblue, which will partner with headspace and Early Childhood Australia to provide tools for teachers to support kids with mental health concerns and provide resources to help students deal with challenges.

Digital mental health services are an important part of national mental health reform and have been identified in the recently endorsed Fifth National Mental Health and Suicide Prevention Plan.

Building a digital mental health gateway was a key part of the Government’s response to the National Mental Health Commission’s Review of Mental Health Programs and Services.

 

NACCHO Aboriginal Health and Smoking : Survey #Nosmokes How #socialmedia supports positive health behaviour

How does accessing the NoSmokes health campaign support anti-smoking behaviour in Aboriginal and Torres Strait Islander youth?

What is this project about?

The aim of this project is to explore how the NoSmokes health campaign supports Aboriginal and Torres Strait Islander youth to deal with smoking situations. We will also explore whether accessing NoSmokes supports young people to stay quit or resist starting smoking.

What are the benefits of the project?
This project will help us to understand more about how online technology and social media can be used to support positive health behaviour, particularly in relation to smoking. You may also learn more about your own confidence in dealing with a number of different smoking situations.

What will I have to do?

To participate you must use /view

1.NoSmokes Facebook page.

VIEW HERE

2. NoSmokes website.

VIEW HERE

3. NoSmokes YouTube channel.

VIEW HERE

4. NoSmokes  Instagram page

VIEW HERE

5.and be 16 years of age or older.

Your participation is voluntary, so you don’t need to take part if you don’t want to. If you choose to take part, you will complete an online questionnaire answering questions about: your experience with smoking; your experience of NoSmokes, your confidence in dealing with different smoking situations. This will take around 20-25 minutes.

If there are any questions in the survey you don’t like, or that you do not feel comfortable answering, then leave that question and move onto the next one. You can complete the survey on your mobile phone or computer. If you change your mind about participating, or are feeling uncomfortable, you can choose to stop the survey at any time by closing the web page or by not pressing the ‘submit’ button. Any data collected before you withdraw will be deleted at the end of the data collection period.

What will happen to my information?

Only the researcher will have access to the individual information provided by participants. Privacy and confidentiality will be assured at all times. The project findings will be used as part of the researcher’s Honours Thesis project, and will be published on the NoSmokes and Ninti One websites. The research may also be presented at conferences and written up for publication.

Only anonymous information will be gathered – you will not be required to provide any identifiable personal information, such as your name or date of birth. No one will know you have taken part in this research from reading the thesis, reports or other publications.

If you are interested in viewing the results of this research, a summary report will be available on the NoSmokes website http://nosmokes.com.au/ in December 2017. You can also request a copy of the final thesis by emailing Neeti Rangnath on u3105740@uni.canberra.edu.au.

Researcher
Neeti Rangnath
Honours Student
Discipline of Psychology, Faculty of Health
University of Canberra, ACT 2601
Email: u3105740@uni.canberra.edu.au
Supervisor
Dr Penney Upton
Associate Professor in Health
Centre for Research and Action in Public Health
University of Canberra, ACT 2601
Ph: 02 6201 2638
Email: penney.upton@canberra.edu.au
Data storage
During the project, the anonymous data will be stored securely on a password protected computer, and then stored securely on the University of Canberra network server. The information will be kept for 5 years, after which it will be destroyed according to University of Canberra protocols.

Ethics Committee Clearance
The project has been approved by the Human Research Ethics Committee of the University of Canberra (HREC 17-83).

Queries and Concerns
If you have any questions or concerns about this project you can contact the researchers, whose details are provided at the top of this form. If you are concerned about the conduct of this project please contact

Mr Hendryk Flaegel, Ethics and Compliance Officer at the University of Canberra (p) 02 6201 5220 (e) humanethicscommittee@canberra.edu.au

There are no anticipated risks associated with participating in this research. However, if completing this questionnaire makes you feel uncomfortable, sad, or angry about your own smoking or the smoking behaviour of someone you know, you are encouraged to visit the following website to find support with smoking-related issues in your state or territory:

http://www.quitnow.gov.au/internet/quitnow/publishing.nsf 

Consent Statement 
I have read and understood the information about the research. I am not aware of any reason that I should not be participating in this research, and I agree to participate in this project. I have had the opportunity to ask questions about my participation in the research. All questions I have asked have been answered to my satisfaction.

Complete consent and start survey here

 

Aboriginal Health #NAIDOC2017 : New Aboriginal-led collaboration has world-class focus on boosting remote Aboriginal health

“One of the clear innovations that our Centre already offers is acknowledging that the principle of Aboriginal community control is fundamental to research, university and health care partnerships with regional and remote Aboriginal communities,”

Ms Donna Ah Chee Congress CEO said it was satisfying to achieve recognition for the strong health leadership and collaboration that already exists in Central Australia ( see editorial Part 3 below)

  ” The centre’s accreditation this week with the National Health and Medical Research Council proved the “landmark research” by consortium members had “huge potential” to address serious indigenous health issues.

The objective is to evaluate problems and find practical solutions fast, to prevent health problems and give speedy but lasting benefits to patients within community,”

Announcing $222,000 in seed funding, Federal Indigenous Health Minister Ken Wyatt see full story PART 2 from the Australian below

Photo above : Traditional Arrernte owners welcome Ken Wyatt MP to Alice Springs to launch the Central Australia Academic Health Science Centre

An academic health science centre in Central Australia is the first Aboriginal-led collaboration to achieve Federal Government recognition for leadership in health research and delivery of evidence-based health care.

The Federal Minister for Indigenous Health and Aged Care, the Hon Ken Wyatt MP, today announced that the Central Australia Academic Health Science Centre (CAAHSC) was one of only two consortia nationally to be recognised as a Centre for Innovation in Regional Health (CIRH) by Australia’s peak funding body for medical research, the National Health and Medical Research Council (NHMRC).

To be successful in their bid, the 11-member consortium was required to demonstrate competitiveness at the highest international levels across all relevant areas of health research and translation of research findings into health care practice.

With NHMRC recognition, the CAAHSC joins an elite group of Australian academic health science centres that have so far all been based in metropolitan areas including Melbourne,

Sydney and Adelaide. The CAAHSC is also in good company internationally, with long established collaborations including Imperial College Healthcare in the UK and Johns Hopkins Medicine in the USA.

The CAAHSC, whose membership includes Aboriginal community controlled and government-run health services, universities and medical research institutes, was formally established in 2014 to improve collaboration across the sectors in support of health.

Such synergy is vital in order to make an impact in remote central Australia, considering the vast geographical area (over 1 million square kilometres) and the health challenges experienced particularly by Aboriginal residents.

The CAAHSC consortium reflects the importance of Aboriginal leadership in successful research and health improvement in Central Australia.

The Chairperson of CAAHSC is Mr John Paterson, CEO of the Aboriginal Medical Services Alliance Northern Territory, the peak body for the Aboriginal community controlled health services sector in the NT.

With the leadership of CEO Ms Donna Ah Chee, Central Australian Aboriginal Congress was the lead partner on the group’s bid to become a CIRH.

The CAAHSC is a community driven partnership, where Aboriginal people themselves have taken the lead in identifying and defining viable solutions for the health inequities experienced in the Central Australia region.

The CAAHSC partners have a long and successful track record of working together on innovative, evidence-based projects to improve health care policy and practice in the region.

Such projects include a study that examined high rates of self-discharge by Aboriginal patients at the Alice Springs Hospital, which in many cases can lead to poor health outcomes.

This research was used to develop a tool to assess self-discharge risk which is now routinely used in care, and to expand the role of Aboriginal Liaison Officers within the hospital.

Another collaborative project designed to address the rising rates of diabetes in pregnant women involves the establishment of a patient register and birth cohort in the

Northern Territory to improve antenatal care in the Aboriginal population.

CAAHSC Chair, Mr John Paterson agrees, saying the CIRH would serve as a model for other regional and remote areas both nationally and internationally, particularly in its governance, capacity building, and culturally appropriate approaches to translational research.

Mr Paterson said he hoped NHMRC recognition would attract greater numbers of highly skilled researchers and health professionals to work in Central Australia, and that local Aboriginal people would become more engaged in medical education, research and health care delivery.

He also hopes that achieving status as a CIRH will be instrumental in attracting further resources to the region, including government, corporate and philanthropic support.

Mr Paterson said the consortium is now focussed on building a plan across its five priority areas: workforce and capacity building; policy research and evaluation; health services research; health determinants and risk factors; and chronic and communicable disease.

This will include development of research support ‘apprenticeships’ for Aboriginal people and pursuit of long-term financial sustainability.

The partners of the Central Australia Academic Health Science Centre include: Aboriginal Medical Services Alliance Northern Territory (AMSANT); Baker Heart and Diabetes Institute; Charles Darwin University; Centre for Remote Health (A joint centre of Flinders University and Charles Darwin University); Central Australian Aboriginal Congress; Menzies School of Health Research; Central Australia Health Service (Northern Territory Health); CRANAplus; Flinders University; Ngaanyatjarra Health Service and the Poche Centre for Indigenous Health and Wellbeing.

1.Chronic Conditions

Chronic diseases are the most important contributor to the life expectancy gap between Indigenous and non-Indigenous Australians. Given their impact on premature mortality, disability and health care utilisation in Central Australia it is unsurprising that chronic disease has become the primary focus for addressing Indigenous Australian health disadvantage.

The Central Australia AHSC has considerable research and translation expertise with those chronic conditions that most impact the Aboriginal Australian population, including diabetes, heart disease, renal disease and depression.

Some of our focus areas are: understanding the developmental origins of adult chronic disease through targeted multi-disciplinary research focused on in-utero, maternal and early life determinants; understanding and preventing the early onset and rapid progression of heart, lung and kidney disease and diabetes within Aboriginal people, and developing and supporting capacity development of the chronic disease workforce within Aboriginal communities and health services.

2.Health Determinants and Risk Factors

In order to support the health of Central Australians, we recognise the importance of transcending boundaries between the biological, social and clinical sciences. The Central Australia AHSC takes an interdisciplinary approach to understanding social gradients, their determinants, and pathways by which these determinants contribute to illness, and consequently to forwarding policy responses to reduce health inequalities.

The Central Australia AHSC is interested in exploring the role of stress, intergenerational trauma and other psychosocial factors, as well as uncovering the biological pathways by which social factors impact on cardiometabolic risk, mental illness and other conditions of relevance to Indigenous communities.

3.Health Services Research

As a regional hub servicing a high proportion of Aboriginal people spread across an extensive area, Central Australia serves as an exemplar environment through which to address critical issues of national importance – for instance, targeted and practical research focused on the National Health and Hospital Reform agenda, the ‘Close the Gap’ reforms and the Indigenous Advancement Strategy.

Through health services research, the Central Australia AHSC is chiefly interested in developing and equipping primary care and hospital services with the skills, methods and tools by which to improve health care quality, appropriateness and accessibility.

Towards this goal, we are involved in developing, trialling, evaluating and establishing the cost-effectiveness of novel health system approaches to the identification, management and prevention of acute care, chronic disease and mental illness

4.Policy Research and Evaluation

The Central Australia AHSC brings together the expertise of leading clinician researchers, public health specialists and health service decision makers.

The Central Australia AHSC provides the capacity to evaluate the systems that underpin change management in health care through policy, protocol and evaluation research, and to support quality improvement processes through health provider training.

While being locally relevant, our works also informs jurisdictional and national health policy and practice in Aboriginal and remote health and implementation of national health reforms.

5.Workforce and Capacity Building

Central Australia’s health care workforce encompasses health care providers in hospitals, remote Aboriginal communities, and outreach services, including Aboriginal health practitioners, nurses, allied health providers, general practitioners and specialists.

Remoteness and the challenging work environment often translate to high levels of health provider staff turnover.

The Central Australia AHSC’s ongoing focus on professional development and capacity building facilitates health work force sustainability by providing relevant training and support and by attracting new health care providers who are also involved in research.

Workforce and capacity building undertaken by the AHSC partners includes the delivery of education programs (including tailored remote and Indigenous health postgraduate awards for doctors, nurses and allied health practitioners), growing research capacity (supervised formal academic qualifications and informal mentoring), and conducting research to inform workforce recruitment and retention.

Part 2 World-class focus on boosting remote health

Alice Springs mother Nellie Impu is part of a grim health statistic profoundly out of place in a first-world nation: one in five pregnant Aboriginal women in the Northern Territory has diabetes.

Photo : Nellie Impu, left, with Wayne, Wayne Jr and nurse Paula Van Dokkum in Alice Springs. Picture: Chloe Erlich

From the Australian July 5

For pre-existing type 2 diabetes, that’s at a rate 10 times higher than for non-indigenous women; more common gestational diabetes is 1.5 times the rate.

Mrs Impu became part of that statistic almost five years ago when she was pregnant with son Wayne. So the announcement of a new central Australian academic health science centre, led by the Aboriginal community-controlled health service sector and bringing together a consortium of 11 clinical and research groups, is a big deal for her and many women like her.

The diabetes treatment she underwent while carrying Wayne will continue for more than a decade as part of a longitudinal study.

“We know there is a link ­between mums with diabetes in pregnancy and outcomes for their babies as they grow, including ­future possibilities of type 2 diabetes, which work like this can help us track,” said research nurse Paula Van Dokkum, who works with consortium member Baker IDI Heart and Diabetes Institute.

Wayne is meeting all his childhood development targets, and his mother said the ongoing association with the centre would help her in “trying to make sure he grows up healthy and strong”.

Announcing $222,000 in seed funding, federal Indigenous Health Minister Ken Wyatt said the centre’s accreditation this week with the National Health and Medical Research Council proved the “landmark research” by consortium members had “huge potential” to address serious indigenous health issues.

“The objective is to evaluate problems and find practical solutions fast, to prevent health problems and give speedy but lasting benefits to patients within community,” Mr Wyatt said.

The academic health science centre model, well ­established internationally, brings together health services, universities and medical research institutes to better produce evidence-based care.

The Alice Springs-based enterprise will aim to tackle a ­cancer-causing virus endemic in indigenous central Australia, its only significant instance outside South America and central Africa.

The human T-lymphotropic virus type 1 causes a slow death over 20 years with leukaemia, chronic cough, respiratory problems and respiratory failure. It can be acquired through breast milk in early childhood as well as through blood or sexual contact.

A recent study found HTLV-1 infection rates in a central Australian indigenous community of more than 40 per cent. One result, the inflammatory disease bronch­iectasis, is a leading cause of death for young adults at the Alice Springs hospital.

The program will also address the soaring demand for dialysis in remote communities, with indigenous Australians five times as likely to have end-stage kidney disease than other Australians.

Alice Springs hospital is home to the largest single-standing ­dialysis service in the southern hemisphere, with 360 patients.

Part 3 Alice Springs: the Red Centre of medical innovation

London, Boston, Toronto, Melbourne … and Alice Springs.

Although there may be little in common between these major cities and the heart of Australia’s outback, an announcement this week brings the Red Centre into the company of international players in translational health research, including prestigious institutions such as Imperial College Healthcare in Britain and Johns Hopkins Medicine in the US.

This week, the Central Australia Academic Health Science Centre was given the official seal of approval by the National Health and Medical Research Council.

The Central Australia consortium was one of only two centres recognised as a centre of innovation in regional health for its leadership in health research and delivery of evidence-based healthcare.

And now there’s opportunity in the Red Centre to do even more.

It may well be the most remote academic health science centre in the world, and perhaps the only academic health science centre in the world led by Aboriginal people. With such esteemed recognition for this remote, Aboriginal-led, evidence-based healthcare collaboration, it is hoped that public and private support will also follow.

As a model well established abroad and gaining momentum in Australia, academic health science centres are partnerships between health services, universities and medical research institutes whose collaborative work ensures that translational health research leads to evidence-based care and better health outcomes for patients.

For the 11 partners behind the Central Australia partnership, recognition as a centre for innovation in regional health acknowledges the outstanding collaboration that has existed in this region for several years, and particularly the leadership offered by the Aboriginal sector.

Working with the other partners in the consortium, Aboriginal community-controlled health services are taking the lead in identifying and defining viable solutions for the health inequities experienced in the region.

The work of the Central Australia partners is practical and responsive.

Interested in resolving what had become a troubling issue at Alice Springs Hospital, a resident physician researcher initiated a study that found nearly half of all admitted Aboriginal patients had self-discharged from the hospital in the past, with physician, hospital and patient factors contributing to this practice.

The research findings were used to develop a self-discharge risk assessment tool that is now routinely used in hospital care, and to expand the role of Aboriginal liaison officers within the hospital.

Considering the vast and remote geographical area — more than one million square kilometres — and the health challenges experienced particularly by Aboriginal residents who make up about 45 per cent of the region’s population of about 55,000 people, the Central Australia consortium faces unique and significant challenges. In this respect, Alice Springs may be more like Iqaluit in the Canadian Arctic than London or Baltimore.

But in other ways this relatively small academic health science centre may be at an advantage.

With its closely knit network of healthcare providers, medical researchers, medical education providers and public health experts working together, community-driven approaches to identifying issues and developing evidence-based solutions have become a standard approach in Central Australia.

In this setting of high need and limited resources, working collectively is sensible, practical and necessary.

Importantly, there is the possibility to do a lot more.

The consortium hopes such recognition will help to attract top healthcare providers and researchers, to increase educational offerings and to develop local talent, especially Aboriginal people.

The evidence is resounding. A research oasis in the desert, this centre for innovation is fertile ground for investment by government, corporations and philanthropists alike.

Donna Ah Chee is chief executive of the Central Australian Aboriginal Congress. John Paterson is chief executive of the Aboriginal Medical Services Alliance Northern Territory.

NACCHO Aboriginal Health #NAIDOC2017 : Recognising the communication gap in Indigenous health care

 ” The communication gap between health professionals and Indigenous Australians has a significant impact on health outcomes

Limited health literacy is not confined to Indigenous people, but it is greatly magnified for speakers of Indigenous languages in comparison, for example, to non-English speaking migrants from countries where a scientific approach to medicine is practised and where these health concepts are already codified.”

Dr Robert Amery Medical Journal Australia NAIDOC Week 2017

 

Introduction Press Release

Communication gap puts Indigenous health at risk

The need for health professionals to have a stronger focus on communication with Indigenous people has been highlighted by the University of Adelaide’s Head of Linguistics, who says some lives are being put at risk because of a lack of patient-doctor understanding.

In a paper published (Monday 3 July) in the Medical Journal of Australia coinciding with the NAIDOC Week theme of Our Languages Matter – Dr Robert Amery has raised concerns not just about language but also a lack of cultural awareness that also impacts on good communication with Indigenous patients.

Dr Robert Amery, who heads Linguistics within the University of Adelaide’s School of Humanities and is a Kaurna language expert, says poor communication can lead to “mistrust and disengagement with the health sector” among

Indigenous patients, leading to a lack of compliance with treatment, and ultimately poor health outcomes.

He says there’s a 16-year gap in life expectancy for Indigenous people living in the Northern Territory compared with non-Indigenous Australians. Of these Indigenous people in the NT, 70% live in remote areas, and 60–65% speak an Indigenous language at home.

“While many speakers of Indigenous languages living in remote areas can engage with outsiders and converse in English about everyday matters, they often have a poor grasp of English when it comes to health communications and other specialised areas,” Dr Amery says.

Miscommunication can be subtle, and previous studies have shown that while both parties think they have understood each other, they can in fact come away with very different understandings.

“Miscommunication isn’t just about language. Some of these difficulties also arise from the interface of communication and culture, which are often derived from differences in worldview,” he says.

“For traditionally oriented Aboriginal people living in remote areas, understanding of disease causation is fundamentally different. Serious diseases, even accidents, are often attributed to sorcery. Germ theory and the immune system are foreign concepts.

“Silence plays an important role in Indigenous cultures. Indigenous people often respond to questions after a prolonged pause, a concept foreign to those doctors who see silence as impolite in their own cultures.

They compensate by filling the silence and disrupting Indigenous patients’ thoughts. There is a simple solution: pause and allow the patient to think.”

He also suggests healthcare professionals avoid the use of “intangible” conceptual English words and vague sentences, instead focusing on factual communication; that they demonstrate how a medical procedure works; and use simple diagrams to explain medical issues.

“These examples may seem plain and obvious, but astoundingly, despite the many hours dedicated to communication in medical education, such concepts are not taught,” Dr Amery says.

“An investment of time in the consult will have immense payoffs over the long term.”

 Download MJA paper here MJA Dr Robert Amery

Published with permission from Robert Amery and Medical  Journal Australia

 See website for references or PDF

The communication gap is most pronounced in remote areas where cultural and linguistic differences are greatest. The close interdependence of language and culture amplifies the gap, such that communication difficulties in these communities run deeper than language barriers alone.

Life expectancy for Indigenous Australians living in remote areas is considerably shorter than for those living in rural and urban areas.6 Figures are not available for the life expectancy of native speakers of Indigenous languages as a cohort, but the gap in life expectancy exceeds 16 years for Indigenous people living in the Northern Territory,7 70% of whom live in remote areas, and 60–65% speak an Indigenous language at home. The life expectancy gap is, of course, multifactorial, although most studies focus on causes of death.8 The communication gap as a contributor is under-rated and under-researched.1,9

An understanding of the Indigenous language landscape is critical to improving communication. In the 2011 Australian census, 60 550 people, or 11.8% of Indigenous respondents, claimed to speak an Indigenous language at home, and 17.5% claimed not to speak English well.10

More have difficulty with specialised language, with common terms such as infection, tumour, high blood pressure, stroke and bacteria often misunderstood. Native Indigenous language speakers communicate in over 100 different traditional languages and live primarily in the NT, the Kimberley region of Western Australia, northern South Australia and northern Queensland, including Torres Strait.

None of these languages have more than 6000 speakers, and many are now reduced to a mere handful, yet each of these languages is a vast storehouse of knowledge built up over thousands of years. It can be daunting to enter a large English-speaking hospital if you communicate in a language spoken by so few people.

Speakers of some languages have shifted to dominant regional languages, such as Murrinh-Patha (Wadeye, NT), while others have shifted to a creole language, such as Kriol (the Kimberley region and the Barkly Tableland area of the NT and North West Queensland).

Aboriginal people often speak distinctive varieties of Aboriginal English that differ from mainstream English. For most Aboriginal people in remote areas, their Aboriginal English is an inter-language variety, in the same way that Japanese speakers have their own distinctive accent and turn of phrase in English, which may be a challenge for medical personnel to understand.

Data might suggest that only a small proportion (less than 10%) of Indigenous adults under 60 years do not speak English well, and that communication issues would therefore not be significant (Box 1).

However, while many speakers of Indigenous languages living in remote areas can engage with outsiders and converse in English about everyday matters, they often have a poor grasp of English when it comes to health communications and other specialised areas. In a study on comprehension of 30 common legal terms (assault, bail, guilty, warrant, etc),11 200 Yolŋu people (north-east Arnhem Land) were surveyed with over 95% unable to correctly identify the meaning of these terms (Box 2).

A parallel health study has not been conducted, but it is likely that understanding of common specialised health terms would be no better. Personal experience supports this view. In 1990, I taught a short course in medical interpreting to a group of Yolŋu students. In teaching the difference between idiomatic and literal language, I introduced an example (“He chucked his guts up”) that I thought everyone would understand. The Yolŋu students interpreted this idiom literally, thinking he ripped out his intestines and threw them in the air. Even simple little things that might be said, such as “let’s keep an eye on it”, can be baffling, because these expressions are often taken literally.

Proportion of Indigenous Australians who speak an Indigenous language and who are reported to speak English “not well” or “not at all”, 2006 and 2011*

Yolŋu comprehension of 30 common legal terms*

Misinterpretations also arise from the interface of communication and culture, here derived from differences in worldview rather than linguistics. In the 1980s, I talked with Tjapaltjarri (skin name, now deceased), a senior Pintupi Aboriginal health worker, about the location of a relative’s house in Alice Springs. Tjapaltjarri referred to various landmarks such as trees and rocks. I asked him about prominent street names including Bloomfield Street. We conversed with full understanding, but I could not follow Tjapaltjarri’s directions. I never paid attention to these landmarks, he never noticed street names. This was not a linguistic issue. It was literally a matter of different worldview. Extrapolate from this example to appreciate the difficulties first language speakers of Aboriginal languages might have in following medical explanations, even when they seemingly speak good English.

These communication gaps are confirmed in health settings. A study of Yolŋu patients undergoing dialysis in Darwin2 identified, through exit interviews, significant misunderstanding of test results despite both patient and renal nurse having revealed that they were satisfied with the communication.

Trudgen9 discusses a Yolŋu patient suffering from severe diabetes and renal failure who was able to avoid dialysis once his condition was explained to him in meaningful terms, and goes on to estimate that 75–95% of communication with Yolŋu patients fails, even with an Aboriginal health worker involved. Aboriginal health workers are not necessarily trained interpreters, nor is interpreting their primary role, although they are often expected to interpret.

How do we improve? Surprisingly simple communication methods, which are easy to teach within mainstream medical education, can help. Trudgen demonstrates how to explain to a Yolŋu patient their 2% residual renal function.9 Many Yolŋu and speakers of other Indigenous languages do not understand the concept of percentages. A picture of a kidney was drawn, shading in the 2% still functioning and showing the remainder, which was sclerosed (Box 3). The patient responded in shock and, no doubt, with better dialysis participation.

Box 3

Template to explain residual renal function of 2% (hatched area) in an otherwise sclerosed kidney (dots)

Aboriginal patients may not be as trusting of medical implements as others. Refusal of an ear examination, for example, may be overcome by allowing such a patient to look through the otoscope to understand how it works. Silence plays an important role in Indigenous cultures.9,12,13

Indigenous people often respond to questions after a prolonged pause, a concept foreign to those doctors who see silence as impolite in their own cultures. They compensate by filling the silence and disrupting Indigenous patients’ thoughts. There is a simple solution — pause and allow the patient to think.

Studies1,2,3,4,14 have identified a widespread belief among Yolŋu people that information is deliberately withheld, mirroring culturally based misconceptions that lead many professionals to believe that Aboriginal patients do not want to know or that they do not experience pain.15

However, several studies1,4,14 clearly demonstrate the desire of Aboriginal people, both from the Top End and from Central Australia, for information about their illnesses and treatment. Effective communication methods, including the use of interpreters, are grossly underutilised, and frequently there is a failure to recognise that patients do not understand.

In a study of 41 Yolŋu people, only 11 found explanations about diagnosis and treatment satisfactory.4 Other studies have shown that even when patients are satisfied, gross misunderstandings may still exist.2 Trudgen9 again gives an example of how this may occur. A doctor explained to a patient that he “could not tell conclusively why [the patient’s] heart was enlarged”. The patient subsequently interpreted this to be that the doctor had no idea why his heart was enlarged and decided not to engage in treatment. Had the doctor avoided use of “intangible” conceptual English words and vague unrevealing sentences, instead focusing on factual communication, this error could have been avoided.

A failure to develop an adequate understanding does run deeper than words. For traditionally oriented Aboriginal people living in remote areas, understanding of disease causation is fundamentally different. Serious diseases, even accidents, are often attributed to sorcery.16,17 Germ theory and the immune system are foreign concepts.

Traditionally oriented Aboriginal people typically have detailed knowledge of anatomy from hunting, butchering and observing nature,9,18 but the perceived function of the kidneys, lungs, pancreas and other internal organs may be quite different. Finding common ground between these understandings is no easy task, but it is important to understand that it may play into medical treatments in the same way as having insight into the use of alternative medicines does in other cultures.

These examples may seem plain and obvious, but astoundingly, despite the many hours dedicated to communication in medical education, such concepts are not taught. Some strategies are provided in Box 4. There is an urgent need to pay more attention to communication needs of remote Aboriginal people.

Communication strategies

A refusal to take Aboriginal languages seriously not only results directly in less than optimal medical outcomes, but also in mistrust and disengagement with the health sector and non-compliance with treatment regimens.3

An investment of time in the consult will have immense payoffs over the long term. We cannot expect our medical students and colleagues to adapt without teaching.

Concepts are simple to grasp with knowledge of the languages and cultures. Is effective establishment of the Aboriginal patient–doctor relationship not one of the more teachable aspects of communication for generations of doctors?

Education is the way forward to a practical and high impact population of medical staff who contribute to the health and pride of the people who are Australia’s national treasures.

Aboriginal Health #NRW2017 : @AHCSA_ and @PAFC @AFL to support new @DeadlyChoices Aboriginal health checks in South Australia

 

” The Deadly Choices program’s intent is to provide a measurable difference in addressing Aboriginal health issues. 

“Aboriginal people have far higher mortality rates than the average population and die at much younger ages. Despite government intentions to ‘close the gap’, the problem isn’t getting any better,

Chronic disease and preventable health conditions are taking a toll on our communities and we need to find innovative ways to move the dial toward better health outcomes.

We hope, with support from the Port Adelaide Football Club, our Deadly Choices initiative will encourage our young people to take responsibility and stop smoking, stay active and look after their own wellbeing, and that of their families.”

Aboriginal Health Council of SA chairperson John Singer

Port Adelaide has signed a memorandum of understanding (MOU) with the Aboriginal Health Council of South Australia Ltd (AHCSA) to deliver Deadly Choices – a program that will build awareness of healthy lifestyle choices and encourage regular health checks.

‘Deadly’ is a common term used to express positivity or excellence within Aboriginal communities, and Deadly Choices is designed to help improve the excellent health choices made by Aboriginal people in South Australia.

Gavin Wanganeen ( right ) won the 1993 Brownlow Medal. Wanganeen is a descendant of the Kokatha Mula people.

The program is based on a successful model used in Queensland since 2009 with the Brisbane Broncos, developed by Adrian Carson and his team and staff at the Institute for Urban Indigenous Health.

That program led to a 1300 per cent increase in Aboriginal and Torres Strait Islander people undergoing health checks.

Deadly Choices provides participants with limited edition merchandise in exchange for taking part in educational programs and undergoing regular health checks.

The merchandise is provided as a ‘money can’t buy’ incentive, with revenue from undergoing health checks used to fund subsequent stages of the program.

Port Adelaide players will support the promotion of the program and encourage participants to take part in the eight-week education program to receive their Deadly Choices footy guernsey.

As part of the program:

  • Education programs will be launched in the Anangu Pitjantjatjara Yankunytjatjara Lands (APY Lands) in collaboration with the Nganampa Health Council in June, in support of Port Adelaide’s WillPOWER program.
  • Curriculum will cover leadership, chronic disease, tobacco cessation, nutrition, physical activity, harmful substances, healthy relationships, access and health checks.
  • Health checks will be provided in the first stage of Deadly Choices by AHCSA-aligned members, which already provided comprehensive primary health care in SA.
  • Long-term partnerships with the South Australian Health and Medical Research Institute (SAHMRI) are being explored to established metropolitan clinics to provide health check services.

Port Adelaide chief executive officer Keith Thomas said the decision to partner with AHCSA is a continuation of Port Adelaide’s commitment to helping forge tangible outcomes for Aboriginal communities in South Australia.

In his CEO Update, Thomas reflected on the fact 70% of Aboriginal deaths are related to chronic disease, while the life expectancy for an Aboriginal person is on average, 10 years less than the wider population.

“We are proud to partner with AHCSA to deliver Deadly Choices across South Australia,” said Mr Thomas.

“The Deadly Choices program perfectly links to the healthy lifestyle messages we promote through WillPOWER and the Aboriginal Power Cup programs.

“We’re very excited to be making a contribution to the health agenda in Aboriginal communities around South Australia.”