The research within the Centre for Research Excellence in Aboriginal Health and Wellbeing spans across three core themes. Below our research projects are outlined within these themes.
Mental Health and Wellbeing
Strengthening social and emotional wellbeing of Australian Aboriginal people: How does racial identity and related self-esteem mediate the mental wellbeing of Aboriginal people?
This is an extension of Cheryl Kickett-Tuckers research on the development of racial identity and related self-esteem of Aboriginal children, youth and adults (using her IRISE measures across the life span).
This research will describe the mediating factors of racial identity and related self-esteem in relation to Aboriginal people's mental wellbeing and identify effective ways to strengthen the social, cultural and emotional wellbeing and identity of Aboriginal children, youth and young adults onwards.
This research will encompass development of new instrumentation, complemented by in depth personal interviews using CPAR methods.
Consulting with the Community to develop an innovative and culturally responsive Empowerment, Healing and Leadership program
The project is being done in collaboration with Kimberley Aboriginal Medical Services Council (KAMSC) Social Emotional Wellbeing Unit.
This project stems from the high rates of Suicide in the Kimberley in 2010. The aims of this project are to strengthen the capacity of community members to empower themselves and others to change their lives, their communities and the systems that are barriers to good social and emotional wellbeing.
The findings will be used to develop an accredited innovative program that is culturally appropriate to the empowerment of Aboriginal people in different geographical locations. The project consists of the following two stages - community and stakeholder consultation; program development.
"Looking Forward" Aboriginal Mental Health Project
This project is a partnership between government and non-government mental health service providers, primary healthcare providers, the CRE & Ruah Community Services.
The Looking Forward Aboriginal mental health project is an initiative that aims to improve the way the mental health system responds to Aboriginal families living with mental health issues and who live in the Armadale State Health Region.
The project is using a participatory action research process that involves reviewing and taking action on what people say in community forums. The community forums are being used to find out what the community members and people working in the sector have to say about their experiences with the mental health system.
Working with families and community groups, the project team will design and develop a culturally safe mental health service framework that will assist service providers, policy makers and managers in the delivery of their services to Aboriginal people. The implementation of this framework will benefit the community and provide a benchmark for those organisations working in mental health to work more effectively with Aboriginal people.
More information on this project is available here.
Family Assessment Tool, Milliya Rumurra, Broome
Milliya Rumurra (MR) is a residential centre providing treatment and rehabilitation to Indigenous community members wishing to address their misuse of alcohol and other drugs (AOD). Currently as part of their formal program MR assess all individuals attending the centre to develop a specific treatment plan to assist each person in addressing their AOD use while they are at the centre. The centre's outreach program informally works with the family of the attending person to help them to understand what the centre is offering and to provide support while their member is receiving treatment. The outreach program also assists both the family and the client with their transition back into the family and community on completion of the program. When looking at the health and social and mental well-being of their clients MR now want to integrate the support service that they offer to the families of their clients and develop a family assessment tool that can more effectively help their workers in developing a specific case plan that engages with the family during the rehabilitation process of their member.
The current project is to work with the management, clinical and outreach team, clients, families, community members and service stakeholders to develop a family assessment tool. This tool will become an integral part of the MR's service and will be used by clinical and outreach team workers to assess the needs of the client's family at the time of intake. The project will utilize the community based participatory research approach. The aim of the assessment tool is to improve the health and quality of the Aboriginal client and their family during their journey through AOD treatment. The final outcome of the project will be the development of a family assessment tool which will be trialed by MR's clinical and outreach team and evaluated for its usefulness and effectiveness.
Recommendations will drive health policy; build community resilience and capacity; inform non-Aboriginal health care professionals' understanding of the need for culturally appropriate health care services; guide health professionals' practice; and guide health policy for the provision of culturally appropriate health services.
Cultural Security and Cultural Competence
The cultural security of Aboriginal mothers birthing in an urban maternity facility: Investigating Aboriginal women's cultural needs; and evaluating the cultural competency, workforce and education needs of midwives
E/Prof Rhonda Marriott (Murdoch University), Tracy Martin (Office of Nursing and Midwifery), Terri Barrett (Statewide Obstetric Support Unit), Assoc Prof Roz Walker (TICHR/CCHR), Dr Tracy Reibel (TICHR), and Distinguished Research Prof Fiona Stanley (UWA)
This project is made up of three objectives. The first is to explore the meanings of 'cultural security' and Birthing on Country for Aboriginal women in the study location. This study will investigate what Aboriginal women want and expect from their health services in relation to a meaningful Aboriginal cultural birthing experience and/or a Birthing on Country maternity model. This study will investigate what would they include in a culturally secure and/or Birthing on Country birth plan that would facilitate real cultural meaning (such as Grandmothers' Law); and explore what Aboriginal women feel are cultural risks to themselves and their children if these requirements are not being met. How Noongar women were historically supported in birth by traditional midwives will be sought through interviews with senior Noongar women able to share that story. This is an important context to be documented as part of this project.
Secondly, is the exploration of what Aboriginal women in the study location consider a 'culturally secure' birth experience would look and feel like in relation to their cultural birth needs (such as Birthing on Country); how they would be best supported by midwives and other staff present at the birth; and what organisational level of cultural security would assist them. The analysis from the first two study objectives will be compared to the key characteristics of culturally competent care and a culturally secure health care environment described in previously published work.
The third objective is to use the findings from objectives one and two to derive requirements for midwifery pre and post registration education programs in order to effectively prepare the midwifery workforce for the diversity of cultural birthing needs of Aboriginal women in the study location. The information will be compared to the national requirements for course accreditation from the Australian Nursing and Midwifery Council (ANMAC); and for individual registration to practice as a midwife with the Australian Health Practitioner Regulation Agency (AHPRA). Recommendations from this component of the study will guide future change processes in midwifery and maternal and infant health care to achieve culturally secure health services for those Aboriginal women; and guide the development of culturally appropriate education content for midwifery programs of study and continuing education programs for midwives.
The importance of culture and connection to country for Nyiapali people
Denise Groves - PhD project, Murdoch University
Denise's PhD is divided into three sections, the spiritual implications of birthing on country, the spiritual, social, and cultural consequences that result when these spiritual connections are broken, and how these connections are being restored and strengthened. She is in the first year of her studies.
Cultural Security for Yamaji (Aboriginal people) within health services in the Midwest Murchison region of Western Australia.
This project aims to create a culturally secure health service for Yamaji (Aboriginal people) in the Midwest/Murchison region of Western Australia. This will be achieved through the mapping of current policies and practices when treating and engaging Aboriginal health consumers across all health sectors, implementation of the 'Cultural Security Framework' (Coffin 2007) within each health sector to show the strengths and weaknesses for priority, and working within each health sector to create strategies/policies and practice to improve areas of weakness. It is hoped that this project with provide evidence that changes can be culturally secure and sustainable.
This project will also take into consideration the existing Department of Health Cultural Respect Implementation Framework and other documentation/policies in regard to this issue.
An arm of the Cultural Security project in the North Metropolitan region has also been established through the PindiPindi Centre as part of improving culturally secure health service delivery to Aboriginal people in the North Metropolitan Health Service Area. This will ensure great research translation across rural, remote and urban settings of the proposed methodology and model. The Framework strategies and actions will be developed by the Cultural Security Aboriginal Leadership Group; this group will provide practical implementation guidance and cultural advice to the program.
Investigation of a culturally secure home visiting model for Aboriginal family and child health support in the Midland community in Western Australia.
Ailsa Munns - PhD project, Curtin University
Supervisors: Professor Desley Hegney, Professor Rhonda Marriott & Associate Professor Roz Walker.
This research project will examine the development, implementation and evaluation of peer led home visiting parenting support for Aboriginal families with young children in the Midland community within the Swan, East Metropolitan region of Western Australia. The age range for children is from birth to four years, after which it is anticipated that they will have more sustained contact in the preschool environment.
Recent studies and reviews have identified the need for improved, innovative ways of parent support and child health service delivery for Aboriginal families, including home visiting. There is recognition that support needs to include trans-generational aspects and be embedded within culture, language and lore. Central to the effectiveness of home visiting is the need to develop, implement and evaluate programs within the broader context of impacting social and cultural factors.
This research is based on the Community Families Program in Halls Creek, WA, which addressed the self-perceived needs of Aboriginal families in partnership with community child health nurses, the families and home visiting parent support workers from the local community.
Participatory action research (PAR), which is a critical methodology, will be used as this can advance descriptive or interpretive approaches, engaging the community members to explore their own needs and directions, taking political, historical, psychosocial and psychocultural viewpoints into consideration. This study will allow Aboriginal Parent Support Workers, an Aboriginal Project Coordinator and the researcher to undertake ten action learning cycles, termed "action learning sets", within a period of 12 months of program development and data collection. Qualitative and quantitative data will be collected and analysed throughout the study, through thematic analysis.
Maternal and Child Health
Western Australian Aboriginal Intergenerational Fetal growth Study (WAAIFS )
This project will investigate determinants of fetal growth across generations, in all Aboriginal mothers and children born in Western Australia between 1980 and 2009, using a novel measure of fetal growth; the percentage of optimal birth weight (POBW). POBW measures the appropriateness of fetal growth for a given gestational age, fetal gender, maternal height and parity, and allows the prevalence and severity of both growth restriction and excessive growth to be assessed.
Using unique data from linked administrative health datasets spanning over 30 years and multilevel models, the study will map the differing contributions of fetal growth to chronic diseases in individuals, the links between maternal fetal growth and that of her offspring, and how the occurrence of medical conditions and pregnancy complications influences that relationship. We will explore the causal pathways involved in the perpetuation of sub-optimal fetal growth across generations, as well as those that are protective.
These investigations will be to inform whether the most important pathways to chronic disease began in grand-maternal environments or in the next generation. The results are likely to provide evidence for when maternal and child health interventions are likely to be most effective for
the prevention of lifelong adult diseases including those influencing reproductive risks.
Implementing the AEDI in the Western Desert
The key objective of this research project is to improve the maternal and child health and wellbeing of Martu communities living in the Western Desert communities of Jigalong, Punmu, Parngurr and Kunawarritji and Newman in the Pilbara. The project is undertaken in partnership with funding through BHP Billiton Iron Ore, Indigenous Community Investment Program 2010-2014. Using Community-based Participatory Action Research methods the project provides the evidence base and conceptual underpinnings to inform and evaluate the new maternal and child health initiatives being developed by World Vision Australia and other stakeholders to improve the social, educational and maternal and child health and wellbeing outcomes of the Western Desert communities.
Specifically the project involves implementing,communicating and disseminating the AEDI results to relevant stakeholders in health and education Aboriginal across the Western Desert communities over the five years 2010-2014. It also involves trialling appropriate tools and communication strategies to share the information with Aboriginal families to build of their knowledge and strengthen community capacity.
There is strong research evidence which confirms the benefits of using the Early Development Index to bring about community level change in Australia and in Canada.