Lecture 2 Flashcards
What are the limitations of population data and indigenous identification in census?
Indigenous populations are typically younger than non-indigenous population
How is the recording of aboriginal people health outcomes different compared with non-aboriginal people?
Aboriginal people are under-identified in health related data collections.
What is the most accurate means of recording indigenous status in health data?
Self-reporting
What is the point of recording indigenous status in health data?
Relevance to quality of care. Not necessarily technical but access to entitlements. Clinician/practice awareness of additional risks and cultural needs.
Need to measure and monitor aboriginal health indicators over time.
What is the point of recording indigenous status in health data?
Relevance to quality of care. Not necessarily technical but access to entitlements. Clinician/practice awareness of additional risks and cultural needs.
Need to measure and monitor aboriginal health indicators over time in order to close the gap and track progress towards closing the gap.
What is the study design used for the descriptive studies conducted on aboriginal people regarding child health?
WA aboriginal child health survey:
State wide representative sample of 1 in 6 aboriginal families with children 0 - 18 years.
Indigenous control and consultation
Sample based on sample of dwellings - area based clustered sample design
84% response rate.
Informed consent confirmation and identification.
Extensive questionnaire, multi-visits
What was the outcome of the case control study of association between kava use and pneumonia in Eastern Arnhem Land aboriginal communities?
226 cases of pneumonia compared against community control. Pneumonia not associated with kava use
What were the limitations of the case control study of kava use in populations with pneumonia in Eastern Arnhem Land Aboriginal communities?
illegal status of kava, mobility of population, a number died
What percentage of people made up control and what percentage made up cases for the study on case control study of kava use in populations with pneumonia in Eastern Arnhem Land Aboriginal communities?
Kava users made up 49% of cases and 46% of controls
What was the event rate seen in the cohort study of coronary heart disease events in aboriginal australians?
12.6/1000 p-years
What factors were associated with Coronary Heart Disease in Aboriginal people?
Hx of diabeetus
Overweight or obese
Smoking
Hypertension
What outcome was seen in the interventions for pregnant ATSI women?
Aim to determine effect of intensive smoking cessation intervention for pregnant Aboriginal women on smoking rates
70% participation rate, 64% GP adherence to treatment protocol
89% in intervention group and 95% control group were smokers at 36 weeks
No significant difference in smoking rates
What are the issues of recruiting aboriginal people in health research?
Community engagement is necessary, time consuming and expensive.
Identify the keyholders and get to know the lay of the land.
Advice/support from reference or advisory group
Link research to health issues that the community consider important
Distance – difficult and expensive to travel to regional & remote communities
Diversity of Aboriginal populations – consider language, cultural protocol of different groups
Cultural awareness & self-reflection
Embed capacity building
Recruitment may take longer than expected
Sample size issues
Budget issues
What are the issues of recruiting aboriginal people in health research?
Community engagement is necessary, time consuming and expensive.
Identify the keyholders and get to know the lay of the land.
Advice/support from reference or advisory group
Link research to health issues that the community consider important
Distance – difficult and expensive to travel to regional & remote communities
Diversity of Aboriginal populations – consider language, cultural protocol of different groups
Cultural awareness & self-reflection
Embed capacity building
Recruitment may take longer than expected
Sample size issues
Budget issues
Identification of aboriginality
How is research ethics approved for research on aboriginal people?
Research needs to be approved by WA aboriginal health ethics committee as well as HREC.
Ethics application has to include letters of support from aboriginal communities and has to incluse statement addressing 6 specific values and ethics.
