http://localhost:8080/xmlui/handle/123456789/5732 Tue, 14 Apr 2026 20:39:21 GMT 2026-04-14T20:39:21Z http://localhost:8080/xmlui/handle/123456789/5744 Title: Mapping pandemic responses in urban Indigenous Australia: Reflections on systems thinking and pandemic preparedness Authors: Fredericks, Bronwyn; Bradfield, Abraham; Ward, James Abstract: Mapping pandemic responses in urban Indigenous Australia: Reflections on systems thinking and pandemic preparedness Bronwyn Fredericks,1,2, * Abraham Bradfield,1 James Ward,2 Sue McAvoy,3 Shea Spierings,2 Agnes Toth-Peter,4 Troy Combo2 1 The University of Queensland Brisbane, QLD 4072, Australia 2 UQ Poche Centre Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland Brisbane, QLD 4072, Australia 3 Centre for the Business and Economics of Health, Faculty of Business, Economics and Law, The University of Queensland Brisbane, QLD 4072, Australia 4 Australian Institute for Business and Economics, The University of Queensland Brisbane, QLD 4072, Australia Submitted: 7 March 2023; Revision requested: 31 July 2023; Accepted: 5 August 2023 Abstract Objectives: We investigate some of the strengths and challenges associated with Covid-19 responses in urban Indigenous communities in Brisbane, Australia. Our research reflects on the interconnected dynamics that impact health outcomes and mitigate or exacerbate the risk of Covid-19 spreading within urban Indigenous communities. Methods: Three systems thinking workshops were held in 2021 with Indigenous and non-Indigenous stakeholders (N15/workshop) from State and Federal services, along with Aboriginal Community Controlled Health Organisations. All worked in the urban Indigenous health sector. Stakeholders produced a Causal Loop Diagram (CLD) incorporating the critical feedbacks determining the dynamics influencing health outcomes. The aim of the research was to help stakeholders’ build awareness of how the structure of the system influences health outcomes. Results: Stakeholders identified 6 key dynamics which have a negative or positive impact on mitigating risks of Covid-19 infection. By mapping these dynamics within a CLD, 7 intervention points were identified. Conclusions: Systems thinking provides a useful tool in identifying the complexities associated with navigating health challenges, but further research is needed to develop frameworks that work in conjunction with Indigenous Australian methodologies. Implications for public health: Indigenous voices and communities must lie central to health responses/policies for Indigenous peoples. When systems thinking is done by or in collaboration with stakeholders it provides a visual language that can help design public health policy. What can be ascertained is that their effectiveness is predicated on systems thinking’s integration with Indigenous methodologies that acknowledges Indigenous self-determination and challenges Eurocentric representations of health and Indigeneity. Keywords: COVID-19, Urban Indigenous Australia, Urban Health, Pandemic Preparedness, Aboriginal and Torres Strait Islander Health Sun, 01 Jan 2023 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/5744 2023-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/5743 Title: A qualitative exploration of the non-financial costs of cancer care for Aboriginal and Torres Strait Islander Australians Authors: Cummins, Rachel; Preston, Robyn; M. Topp, Stephanie Abstract: A qualitative exploration of the non-financial costs of cancer care for Aboriginal and Torres Strait Islander Australians Rachel Cummins,1,† Robyn Preston,2,3, * Stephanie M. Topp,4 Judy Taylor,3 Sarah Larkins,3 Emily Callander,5,6 Lorraine Bell,7,8 Brian Arley,9 Gail Garvey7,10 1 Djiru/Jirrabal/Bwgcolman, College of Medicine and Dentistry, Bebegu Yumba, James Cook University, Townsville, Australia 2 Public Health, College of Science and Sustainability, School of Health, Medical and Applied Sciences, CQUniversity, Townsville, Australia 3 College of Medicine and Dentistry, James Cook University, Townsville, Australia 4 College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia 5 Monash University, School of Public Health and Preventive Medicine, Melbourne, VIC 3004, Australia 6 Health Services Management, University of Technology Sydney, School of Public Health, Sydney, Australia 7 Menzies School of Health Research, Darwin, Northern Territory, Australia 8 Australian e-Health Research Centre CSIRO, Brisbane, Queensland, Australia 9 Daru, Tudugal, Menzies School of Health Research, Charles Darwin University, Darwin, Australia 10School of Public Health, Faculty of Medicine, The University of Queensland, Darwin, Australia Submitted: 29 December 2022; Revision requested: 1 August 2023; Accepted: 5 August 2023 Abstract Objective: Knowledge is growing about cancer care and financial costs for Aboriginal and Torres Strait Islander people. However, much remains unknown about the true costs of cancer care, encompassing financial, emotional, and spiritual aspects. We aimed to explore and explain how non-financial costs affect the health-seeking behaviours of these clients. Methods: Following Indigenous research protocols, this research was led by Aboriginal and Torres Strait Islander researchers and guided by Indigenous Hospital Liaison Officers. In-depth interviews and focus groups were conducted with 29 participants (Aboriginal and Torres Strait Islander cancer clients, their carers, and cancer-care professionals) at two Queensland public hospitals. Results: Four interwoven themes encompass non-financial costs of healthcare: leaving home and family; loss of control during cancer treatment; health of the spirit; social costs. The Aboriginal relational concept of ‘being held’ is useful in considering client, family, and carer as central to care with the Indigenous Hospital Liaison Officer two-way interpreting between the care and client team. Implications for Public Health: Framing the reasons that clients and carers have difficulty in engaging in treatment as ‘costs’ enables a focus on how the health system itself is implicated in the disengagement of Aboriginal and Torres Strait Islander clients from treatment. Keywords: Aboriginal and Torres Strait Islander, cancer, out of pocket costs, social costs, barriers to care Sun, 01 Jan 2023 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/5743 2023-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/5742 Title: An outbreak of acute rheumatic fever in a remote Aboriginal community Authors: Egoroff, Natasha; Bloomfield, Hilary; Gondarra, Wanamula Abstract: An outbreak of acute rheumatic fever in a remote Aboriginal community Natasha Egoroff,1,2,3, * Hilary Bloomfield,2,3 Wanamula Gondarra,2 Brando Yambalpal,2 Terrence Guyula,3 Demi Forward,2 Gemma Lyons,2 Emer O’Connor,2,3,5 Lou Sanderson,2 Michelle Dowden,6 Desley Williams,3 Jessica de Dassel,3 Pasqualina Coffey,3 Elizabeth Rrapa Dhurrkay,2 Veronica Gondarra,2 Deborah C. Holt,4 Vicki L. Krause,3 Bart J. Currie,4,5 Kalinda Griffiths,4,7,8 Karen Dempsey,2 Anna Glynn-Robinson1 1 National Centre for Epidemiology and Population Health, Australian National University, Australia 2 Miwatj Health Aboriginal Corporation, Australia 3 Centre for Disease Control, Northern Territory Health, Australia 4 Menzies School of Health Research, Charles Darwin University, Australia 5 Rheumatic Heart Disease Australia, Australia 6 One Disease, Australia 7 University of New South Wales, Australia 8 University of Melbourne, Australia Submitted: 30 January 2023; Revision requested: 8 July 2023; Accepted: 12 July 2023 Abstract Objectives: We describe the public health response to an outbreak of acute rheumatic fever (ARF) in a remote Aboriginal community. Methods: In August 2021, the Northern Territory Rheumatic Heart Disease Control Program identified an outbreak of acute rheumatic fever in a remote Aboriginal community. A public health response was developed using a modified acute poststreptococcal glomerulonephritis protocol and the National Acute Rheumatic Fever Guideline for Public Health Units. Results: 12 cases were diagnosed during the outbreak; six-times the average number of cases in the same period in the five years prior (n=1.8). Half (n=6) of the outbreak cases were classified as recurrent episodes with overdue secondary prophylaxis. Contact tracing and screening of 11 households identified 86 close contacts. Conclusions: This outbreak represented an increase in both first episodes and recurrences of acute rheumatic fever and highlights the critical need for strengthened delivery of acute rheumatic fever secondary prophylaxis, and for improvements to the social determinants of health in the region. Implications for Public Health: Outbreaks of acute rheumatic fever are rare despite continuing high rates of acute rheumatic fever experienced by remote Aboriginal communities. Nevertheless, there can be improvements in the current national public health guidance relating to acute rheumatic fever cluster and outbreak management. Key words: acute rhematic fever, outbreak, public health response, group A Streptococcus, notifiable disease, rhematic heart disease Sun, 01 Jan 2023 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/5742 2023-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/5741 Title: Changing conversations about family violence in regional Western Australia: A primary prevention communication case study Authors: Fordham, Helen; Greville, Heath; Moran, Monica Abstract: Changing conversations about family violence in regional Western Australia: A primary prevention communication case study Helen Fordham,1 Heath Greville,2 Monica Moran,2 Dane Waters,3 Sandra C. Thompson2, * 1 Media and Communications, School of Social Sciences, The University of Western Australia, Australia 2 Western Australian Centre for Rural Health, University of Western Australia, Australia 3 Health Communication Resources, Australia Submitted: 6 March 2023; Revision requested: 21 August 2023; Accepted: 25 August 2023 Abstract Objective: To illuminate the enablers and challenges of implementing a communication strategy designed to support Community, Respect, Equality (CRE) and a family and domestic violence (FDV) primary prevention plan in a regional Western Australian town. Method: This research draws on documentation and interviews with members of Leading Lights, an advocacy group arising from a collaboration of local organisations to communicate the goals and priorities of the CRE action plan. Interviews explored how primary prevention messages were promoted to foster supportive community attitudes toward addressing the drivers of FDV. Results: The initiative fostered a learning community that coordinated public messaging about the drivers of FDV for organisations pledged to the CRE values. The diffusion of messaging was affected over time by inconsistent staffing, discontinuities in resourcing and individual organisational commitment, and concerns about gender equality messaging. Conclusion: The communications strategy increased awareness of the drivers of FDV among the members of the Leading Lights. In turn, this group produced media content that made visible each organisation’s commitment to addressing the attitudes and behaviours that enable FDV. Implications for public health: Community collaborations need time, resourcing, and coordination to sustainably prompt changes in social norms that underpin violence. Key words: family and domestic violence, primary prevention, gender equality, strategic communication Sun, 01 Jan 2023 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/5741 2023-01-01T00:00:00Z