Wendy Foley

It puts a human face on the researched--A qualitative evaluation of an Indigenous health research governance model.

Objective: To describe the Inala Aboriginal and Torres Strait Islander Community Jury for Health Research, and evaluate its usefulness as a model of Indigenous research governance within an urban Indigenous primary health care service from the perspectives of jury members and researchers.

Family food work: lessons learned from urban Aboriginal women about nutrition promotion.

This article reports on ethnographic study of urban Aboriginal family food and implications for nutrition promotion. Data were collected over 2 years through in-depth interviews and participant observation in groups conducted through Indigenous organisations in a suburb of Brisbane. Issues when organising family food include affordability, keeping family members satisfied and being able to share food, a lack of cooking ideas, the accessibility of nutrition information, additional work involved in ensuring healthy eating, and a desire for convenience. Many different health professionals provide nutrition advice, often directing it towards individuals and not providing adequate guidance to facilitate implementation. The easiest advice to implement worked from existing household food practices, skills and budget. Cooking workshops helped to provide opportunities to experiment with recommended foods so that women could confidently introduce them at home. Aboriginal women are concerned about healthy eating for their families. Disadvantage can limit dietary change and the complexity of family food work is often underestimated in nutrition promotion. Household, rather than individual, framing of nutrition promotion can lead to more sustainable healthy eating changes.

Closing the gap by increasing access to clinical dietetic services for urban Aboriginal and Torres Strait Islander people

Aim: Late in 2010, the dietetic clinic in a Brisbane Indigenous health service increased from one to four days/week. This article presents research to assess the impact of this on access for urban Aboriginal and Torres Strait Islander people to dietetic services. Methods: Clinic data on referrals and attendance before and after this change are compared. Focus groups with staff and in-depth interviews with 13 patients were conducted to ascertain staff and patient experiences of the clinic changes. Results: The additional time allowed the dietitian to develop a stronger presence in the community and clinic. This ensured that the dietetic service was culturally safe for clients and strengthened team approaches to patient care in the clinic. Despite space limitations, new referrals more than doubled and occasions of service tripled. New patients were more likely to attend an appointment with the dietitian in 2011 than in 2010 (P < 0.001) and the proportion of patients who did not attend appointments without rescheduling decreased significantly (P = 0.006). Conclusions: Various factors contributed to improved access for Aboriginal and Torres Strait Islander people to dietetic care. These included fostering the dietitians cultural awareness and building trust with Indigenous community members, making the dietetic service culturally safe for clients; connecting with patients through appropriate communication styles and inter-professional teamwork. Providing an expanded and culturally safe dietetic service improved the availability, acceptability and appropriateness for Aboriginal and Torres Strait Islander people.

Putting urban Aboriginal and Torres Strait Islander food insecurity on the agenda

Food insecurity adversely affects diet quality, physical, mental and social wellbeing and the capacity to act on health advice recommended by primary healthcare providers. In this article, an overview of the neglected issue of food insecurity in urban Aboriginal and Torres Strait Islander communities is provided. Policy and action on food security for urban Aboriginal and Torres Strait Islander people is reviewed, and it is argued that for primary health care to better address food insecurity, an evidence base is needed to understand the experiences of individuals and households and how to work effectively to support food insecure clients.

Security in the New Millennium: A Debate in the South Pacific on Peace and Security: Alternative Formulations in the Post Cold War Era

During the Cold War, Pacific security issues were focused on the external security concerns of the larger nations that border the Pacific Ocean rather than on the small island states and territories themselves. The island populations have been characterized more often as passive victims of external international relations1 than as the main actors in securing their region. There is, however, a growing literature focusing on security issues within the Pacific states and territories themselves.2 This literature addresses regional concerns from political, economic, environmental, health, and social to military and law and order issues (Henderson 2005: 9; Lawson 2003: 7).

Ethics of Care and Urban Aboriginal and Torres Strait Islander Breastfeeding beyond Three Months

Background: Although early cessation of breastfeeding is common in Australia, as in other industrialised nations, higher proportions of Indigenous mothers cease breastfeeding in the first three months in comparison with other Australian mothers. Methods: Twenty urban Aboriginal and Torres Strait Islander mothers of infants aged 3 to12 months participated in in-depth, semistructured interviews which explored the mothers’ experiences of infant feeding, and the advice and support they received from health professionals. Data were analysed thematically, using an ethics of care lens. Results: Three themes arising from the data are presented here: the impact of care on breastfeeding trajectories, relational support, and mother-centred care. Professional care was found to have a strong influence on breastfeeding initiation and duration. Caring relationships with health professionals which prioritise continuity of care and attention to mothers’ and infants’ specific needs build mothers’ trust in their health carers and their own capacities to breastfeed and in turn facilitate positive breastfeeding outcomes. Mother-centred care in hospital, during clinic follow-up, home visits or phone calls facilitates timely identification of mothers’ feeding doubts or problems and initiation of solutions to breastfeeding problems. Empathic mother-centred infant feeding care is especially important for mothers with limited support at home. Conclusion: In this research we saw that when health professionals working with urban Aboriginal and Torres Strait Islander mothers demonstrate an ethic of care, which is characterised by culturally safe, mother-centred, relational support, they can positively influence breastfeeding initiation and duration beyond three months. To support urban Indigenous mothers to breastfeed, policy and services need to embrace relational, mother-centred care.