Jennifer Browne

Use of participatory research and photo-voice to support urban Aboriginal healthy eating

The aim of this research was to work collaboratively with an urban Aboriginal community to understand meanings of food and food insecurity and strengthen responses to this issue. The project took place at the Wathaurong Aboriginal Cooperative in Geelong, South Eastern Australia in 2009-2010. Photo-voice research methods were used to explore meanings of food and food insecurity. This identified that food selections were influenced by family harmony, collectivism and satiation of hunger with cheap high carbohydrate and fat foods. People were also proud of their hunter-gatherer heritage and saw the Wathaurong Aboriginal Cooperative as leaders in healthy food provision. Action research cycles were used to develop responses including plates depicting healthy food portions, social cooking opportunities, development of a cooking television series and a specialised cook-book. The partnership required researchers to listen carefully to respond to needs of the Wathaurong Aboriginal Cooperative, and this meant adapting research plans to suit the local environment and community partner needs. There is potential for Aboriginal organisations to provide further leadership for healthy eating and food security through workplace food policies and partnerships with food security agencies. Use of Aboriginal nutrition knowledge to provide nutrition education may be useful in health promotion approaches.

Aboriginal health policy: is nutrition the 'gap' in 'Closing the Gap'?

Objective: To examine the extent to which nutrition has been prioritised in national Aboriginal and Torres Strait Islander health policy.

A qualitative evaluation of a mentoring program for Aboriginal health workers and allied health professionals

Objective: Effective partnerships between Aboriginal Health Workers and non‐Aboriginal health professionals are essential to achieve Aboriginal health outcomes. This study aimed to evaluate a mentoring workforce development strategy for Aboriginal Health Workers and non‐Aboriginal allied health professionals.

Early childhood nutrition concerns, resources and services for Aboriginal families in Victoria

Objective: To investigate the child nutrition concerns of Aboriginal families with young children attending Aboriginal health and early childhood services in Victoria; training needs of early childhood practitioners; and sources of nutrition and child health information and advice for Aboriginal families with young children.

Sectoral system capacity development in health promotion: evaluation of an Aboriginal nutrition program

Issue addressed The study examined effective ways to build the capacity of health organisations and professionals in the public health sector to reduce Aboriginal chronic disease risk factors. It investigated the capacity-building strategies of the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) nutrition team in the facilitation of the statewide implementation of the Victorian Aboriginal Nutrition and Physical Activity Strategy 2009-2014 (VANPAS). Methods Using a qualitative design, the study analysed the VACCHO program from 2009-2014 across five domains of capacity development: workforce, resources, organisations, partnerships and leadership. Data were sourced from archival program documents and 62 semi-structured participant interviews. Results Diverse Aboriginal and non-Aboriginal professional, organisation representatives and community participants engaged in the implementation of the VANPAS. The VACCHO team used the VANPAS to solidify participant buy-in, strengthen workforce effectiveness, increase health promotion and resource appropriateness, improve organisational policy and build an evidence-base through collaborative dialogue using action-reflection principles. Conclusion A credible, high-profile Aboriginal community led and evidence-based statewide program and a commitment to dialogue through action-reflection provided a meaningful basis for both Aboriginal community and mainstream organisational engagement. Upon this foundation, the VACCHO team built a coherent sectoral system with increased capacity to enhance the nutrition of Aboriginal Victorians. So what? In an historical context of mistrust and unmet expectations, program implementation methods that build confidence amongst collaborating Aboriginal and non-Aboriginal health agencies is fundamental to building capacity to enhance Aboriginal nutrition and health.

Food and nutrition programs for Aboriginal and Torres Strait Islander Australians: an overview of systematic reviews

Objective To provide an overview of previous reviews of programs that aimed to improve nutritional status or diet-related health outcomes for Aboriginal and Torres Strait Islander peoples, in order to determine what programs are effective and why. Methods A systematic search of databases and relevant websites was undertaken to identify reviews of nutrition interventions for Aboriginal and Torres Strait Islander Australians. Pairs of reviewers undertook study selection and data extraction and performed quality assessment using a validated tool. Results Twelve papers reporting 11 reviews were identified. Two reviews were rated high quality, three were rated medium and six were rated low quality. The reviews demonstrated that a positive effect on nutrition and chronic disease indicators can be a result of: 1) incorporating nutrition and breastfeeding advice into maternal and child health care services; and 2) multifaceted community nutrition programs. The evidence suggests that the most important factor determining the success of Aboriginal and Torres Strait Islander food and nutrition programs is community involvement in (and, ideally, control of) program development and implementation. Conclusions Community-directed food and nutrition programs, especially those with multiple components that address the underlying causes of nutrition issues, can be effective in improving nutrition-related outcomes. What is known about the topic? More effective action is urgently required in order to reduce the unacceptable health inequalities between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Food insecurity and nutrition-related chronic conditions are responsible for a large proportion of the ill health experienced by Australias First Peoples. What does this paper add? This narrative overview of 11 reviews published between 2005 and 2015 provides a synthesis of the current evidence for improving Aboriginal and Torres Strait Islander nutrition across the lifespan. The findings suggest that community-based and community-controlled programs, especially those with multiple components that address the underlying causes of nutrition issues, have the greatest potential to improve nutrition-related health outcomes. What are the implications for practitioners? Food and nutrition programs that are initiated and designed by local Aboriginal and Torres Strait Islander people are most likely to be effective. Nutrition and breastfeeding education and advice should be consistently incorporated into maternal and child healthcare services. Nutrition issues should be addressed through multifaceted approaches that address improving individual knowledge and skills, as well as strategies that increase access to nutritious food and provide a healthy food environment.

Experiences of urban Australian Indigenous peer mentors in a non-communicable disease prevention program

This paper describes urban Indigenous Australian experiences of a peer mentor program (PMP) aiming to reduce non-communicable disease (NCD) risks and discusses its implications for future policy and practice. Much of the inequitable mortality for Indigenous Australians is related to NCD incidence. Using a qualitative approach the study reported here explored 21 peoples experiences as peer mentors in an NCD risk reduction PMP, which took place between 2009 and 2011. Four key themes were identified, including community networks, collective wellbeing, skills development and problem solving, and sustainability. The PMP allowed for inclusiveness of individual strengths, diversity and cultural knowledge. Formal networks provided sustainability and information while peer informal networks provided increased participation, knowledge dissemination, practice of health-promoting skills and provision of support. Inclusion of collective cultural elements, such as connections to Elders, families, children and Country were particularly important for the peer mentors in this study.

Exploring the impact of Aboriginal health placement experiences on the preparation of dietetic graduates for practice with Aboriginal communities: Aboriginal health dietetic university placements

AIM A health workforce with the ability to practice with Aboriginal communities is crucial to bridge the health gap between Aboriginal and non-Aboriginal Australians. This study aimed to explore the impact of university Aboriginal health placements on preparing dietetic graduates for practice with Aboriginal communities. METHODS A mixed methods sequential explanatory design was used. A sample of 594 dietetic graduates was invited to complete a survey that identified Aboriginal health experiences and measured attitudes and self-confidence towards working in Aboriginal health using a five-point Likert scale. Participants were divided into placement versus no-placement groups and compared using chi-squared tests. Sixteen of 33 participants who had completed an Aboriginal health placement were invited to participate in a semi-structured interview to explore how placement influenced practice with Aboriginal communities. Interviews were analysed using content analysis. RESULTS A final sample of 120 participants showed that placement participants reported significantly higher self-confidence towards working in Aboriginal health compared with no-placement participants (No-placement = 35% agree, 36% neutral, 29% disagree; Placement = 74% agree, 11% neutral, 16% disagree; χ2 (2, 88) = 9.4; P = 0.01). Fifteen participants were interviewed. Interview data indicated that situated learning experiences, breaking down stereotypes, empathy through learning from Aboriginal people, and Aboriginal health role-models were key components of Aboriginal health placements in preparing dietetic graduates for practice with Aboriginal communities. CONCLUSIONS The results suggest that Aboriginal health placements may be an effective strategy for preparing dietetic graduates for practice with Aboriginal communities. The feasibility of placement or alternative curriculum content needs to be explored.

Coverage of Aboriginal and Torres Strait Islander Nutrition in major Australian newspapers, 1996-2015

Objective: To examine the extent and nature of coverage of Aboriginal and Torres Strait Islander nutrition issues in major Australian newspapers over two decades.

Determining the reach and capacity of rural and regional aboriginal community food programs in Victoria

In recognition of the critical need to improve food security for Aboriginal people in Victoria, the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) partnered with SecondBite, an Australian food rescue organisation. In 2013, the two organisations initiated a crosssectional survey of community food programs (CFPs) targeting Victorian Aboriginal people. CFPs describe any initiative that provides free or subsidised food to vulnerable people.