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Purpose: Well-being is a complex, multi-dimensional, dynamic, and evolving concept, covering social, economic, health, cultural and spiritual dimensions of human living, and often used synonymously with happiness, life satisfaction, prosperity, and quality of life. We review the existing key wellbeing frameworks applied in Australia both for the wider public and Indigenous peoples. The aim is to provide a comprehensive overview of various applied frameworks, along with a critical analysis of domains or dimensions comprising those frameworks, and to analyse the role of nature in those frameworks. Methodology: We conducted a critical analysis of the main frameworks applied in Australia to date to measure the well-being of the mainstream (mainly non-Indigenous) and Indigenous populations. This study is particularly timely given the Australian Government's interest in revising the well-being frameworks as mentioned in the Government "Measuring What Matters" statement. Results: The existing well-being frameworks in Australia either overlook or hardly consider the role of nature and its services which are important to support human well-being. Likewise, for Indigenous peoples "Country" (Indigenous clan land) is vital for their well-being as their living is imbued with "Country". The role of nature/"Country" needs to be considered in revising the well-being frameworks, indicators and measures to inform and develop appropriate policies and programs in Australia. Conclusion: To develop appropriate welfare policies and programs for achieving socio-economic and other wellbeing outcomes, it is essential to evolve and conceptualize wellbeing frameworks (and related indicators and measures) in line with people's contemporary values, particularly considering the role of nature and its services. [ABSTRACT FROM AUTHOR]

A 10-year review of the 2008 Council of Australian Governments' (COAG) Close the Gap Strategy identified the lack of involvement of Indigenous people in developing policies as a key reason health disparities persist. It also posits that disconnection from Country and culture have been crucial factors. Physical and mental health cannot be separated from spiritual health and well-being amongst Indigenous Australians. This article describes the co-development of a cultural enrichment research study with Indigenous Elders, health service leaders, and community members that places culture at the centre of care to augment traditional Western mental health management. The study has been overseen and nurtured from its inception by a governance board of Traditional Custodian Elders and an Advisory Group of Indigenous health workers. Qualitative data were collected through community 'zoom- yarns ' between an Indigenous research assistant and 44 community members during COVID-19 lockdowns. These yarns were analysed through an innovative, constructivist, multi-perspectival discursive grounded theory method. Findings have led to an Elder-governed adjuvant cultural therapy which is currently being trialled and will be evaluated using the same multi-perspectival discursive grounded theory research methodology. One third of all Indigenous Australians now live in capital cities, so developing models to bring culture and Country into urban health facilities are becoming increasingly important. The Indigenous-led research approach outlined in this paper suggests a model for engaging Indigenous communities that mainly distrust Western research and have been failed by Western mental health care. It has the potential to shape future policy. [ABSTRACT FROM AUTHOR]

Contemporary American Indian communities experience a disproportionately high rate of specific mental health concerns, including psychiatric disorders as defined by professional psychology. Although integrating mainstream mental health services and Indigenous traditional healing (ITH) has been presented as a promising approach to addressing these inequities, such integration necessitates in-depth exploration and consideration of ITH. To that effect, this article provides a thematic analysis of an interview with an urban American Indian traditional healer who reflected on more than 4 decades of therapeutic experience. Based on this analysis, we identified two major themes. The first theme, Expansive View of ITH, reflects this healer's conceptualization and understanding of the therapeutic process while the second theme, Guiding Principles of ITH, explicates the foundational commitments that shape and guide this healer's application and practice of ITH. These insights reinforce previous observations made by scholars of Indigenous health and well-being that challenge dominant Euro-American perspectives and call for transformative change in psychology research and practice, advocating for professional consideration of a broader range of therapeutic rationales, traditions, and practices than what is common within the field. Public Significance Statement: This thematic analysis of an interview with an American Indian healer provides an illustration of how Indigenous traditional healing is conceptualized and practiced. The findings underscore the need for transformative change in psychology research and practice, advocating for professional consideration of a broader range of therapeutic rationales, traditions, and practices. [ABSTRACT FROM AUTHOR]

Background: People experiencing psychosis are at greater risk of physical health conditions and premature mortality. It is likely that Indigenous Māori youth, who experience additional systemic inequities caused by settler-colonisation, face even greater physical health and mortality risks following a diagnosis of first-episode psychosis. Objective: Compare Māori and non-Māori for risk of hospitalisation and mortality for up to 15 years following first-episode psychosis diagnosis. Methods: A cohort (N = 14,122) of young people (16–24 years) with first-episode psychosis diagnosis between 2001 and 2019 were identified. Using crude Kaplan–Meier and adjusted Cox proportional hazards models, Māori (n = 5211) and non-Māori (n = 8911) were compared on hospitalisation and mortality outcomes for up to 15 years. Results: In the 15 years following first-episode psychosis diagnosis, Māori had higher adjusted risk of all-cause mortality (hazard ratio = 1.21, 95% confidence interval = [1.01, 1.45]), hospitalisation with diabetes (hazard ratio = 1.44, 95% confidence interval = [1.15, 1.79]), injury/poisoning (hazard ratio = 1.11, 95% confidence interval = [1.05, 1.16]), general physical health conditions (hazard ratio = 1.07, 95% confidence interval = [1.02, 1.13]) and also appeared to be at greater risk of cardiovascular hospitalisations (hazard ratio = 1.34, 95% confidence interval = [0.97, 1.86]). Kaplan–Meier plots show hospitalisation and mortality inequities emerging approximately 4–7 years following first-episode psychosis diagnosis. Conclusions: Māori are at greater risk for hospitalisation and premature mortality outcomes following first-episode psychosis. Early screening and intervention, facilitated by culturally safe health service delivery, is needed to target these inequities early. [ABSTRACT FROM AUTHOR]

The article focuses on the final issue of 2024, which compiles nine insightful articles that delve into critical themes in social work practice and policy. Topics include the identity construction of social workers, client perceptions of care, reflexive analyses of participatory research methodologies, and the lived experiences of diverse individuals, emphasizing the significance of context and critical reflection in ethical social work.

The objective of this article is to summarise the current knowledge regarding the prevalence of six rheumatological conditions in indigenous Australians – rheumatoid arthritis (RA), osteoarthritis (OA), osteoporosis (OSP), systemic lupus erythematosus (SLE), gout and musculoskeletal (MSK) pain. Online medical literature databases were searched for 'indigenous', 'Aboriginal' and 'Torres Strait Islander', as well as the names of the six conditions. Other included search terms were 'crystal', 'urate', 'arthritis' and 'arthropathy'. No limitations were placed on publication data or language. Forty‐five articles examining the prevalence of the six conditions were identified. Based on the published literature, SLE appears to have a higher prevalence, while RA appears to have a lower prevalence in indigenous Australians compared to the non‐indigenous community. MSK pain is prevalent, has a significant impact on indigenous people and is perceived as an important area of need. There is a paucity of data regarding these conditions in indigenous Australians. This may be impacted by the uncertainty of case ascertainment by self‐report, differences in disease phenotypes and prevalence between the metropolitan compared to the rural or remote indigenous population, and difficulty with access to healthcare. Further studies in conjunction with local indigenous communities are needed to accurately determine the burden of rheumatological disease in the indigenous population. This will assist with resource and workforce planning to deliver culturally appropriate interventions. Strategies for future clinical work and research include the development and dissemination of culturally safe rheumatology resources, rheumatology training of Aboriginal Health Workers and wider integration of rheumatology clinics into community‐controlled Aboriginal Health Services. [ABSTRACT FROM AUTHOR]

Background: Use of immune checkpoint inhibitors is growing, but clinical trial data may not apply to Indigenous patients or patients living in remote areas. Aims: To provide real‐world incidence of immune‐related adverse events (irAE) in the Top End of the Northern Territory and compare incidence between demographic subgroups. Methods: This retrospective, observational, cohort study collected data from electronic records of patients living in the Top End with solid organ cancer treated with immunotherapy between January 2016 and December 2021. The primary outcome was cumulative incidence of any‐grade and severe irAE. Secondary outcomes were overall survival, treatment duration and reason for treatment discontinuation. Results: Two hundred and twenty‐six patients received immunotherapy. Forty‐eight (21%) lived in a remote or very remote area, and 36 (16%) were Indigenous. Cumulative incidence of any‐grade irAE was 54% (122/226 patients); incidence of severe irAE was 26% (59/226 patients). Rates were similar between Indigenous and non‐Indigenous patients of any‐grade (42% vs 56%, P = 0.11) and severe (11% vs 18%, P = 0.29) irAE. However, Indigenous patients had shorter treatment duration, more frequently discontinued treatment due to patient preference and appeared to have shorter median overall survival than non‐Indigenous patients (17.1 vs 30.4 months; hazard ratio (HR) = 1.5, 95% confidence interval (CI) = 0.92–2.66). There was no difference in mortality between remote and urban patients (median overall survival 27.5 vs 30.2 months; HR = 1.1, 95% CI = 0.7–1.7). Conclusions: Rates of irAE in our cohort are comparable to those in the published literature. There was no significant difference in any‐grade or severe irAE incidence observed between Indigenous and non‐Indigenous patients. [ABSTRACT FROM AUTHOR]

Indigenous Peoples in Canada experience inequities in behavioral health outcomes stemming from colonial subjugation, including tacit cultural assimilation through health care. Indigenous communities assert that culturally commensurate health interventions improve wellbeing. This study, conducted with clients and staff at a First Nations behavioral health treatment program, sought to identify how respondents conceived of the therapeutic endeavor with respect to possibilities for remedying colonial injuries such as the abuses of the Indian Residential Schools (IRSs). Thematic analysis of 32 interviews revealed that targeted therapeutic goals as well as specific counselor qualities were important for a positive therapeutic experience for those in the program. Ultimately, assimilative practices, such as the IRSs of the past and mainstream behavioral health treatment programs in the present may collectively contribute to the continuation of inequities in health outcomes for Indigenous Canadians. Decolonizing the therapeutic endeavor offers a potential avenue for positive change. [ABSTRACT FROM AUTHOR]

There is widespread and growing support and requirement for researchers and larger organisations to collaborate with communities. This ensures that social, educational, or health programmes are relevant and acceptable and address the needs of groups that experience inequity. There is limited research about the processes and approaches that impact successful collaboration. The aim of this study was to identify the best‐practice processes used to develop and sustain collaborative partnerships between community members and formal organisations in Aotearoa New Zealand. Using a qualitative case study methodology and guidance from our community advisory group, we selected three effective collaborations with groups that experienced inequity in Aotearoa New Zealand. We examined these by reviewing their publicly available documents and conducting focus group discussions and interviews with key stakeholders. We coded and analysed transcriptions thematically to develop case study summaries of findings and then conducted cross‐case analysis to identify themes inherent in the data. Seven themes emerged from the data: (1) work together under Te Tiriti to ensure that collaborations are built on the articles of this founding document of Aotearoa New Zealand; (2) start before the beginning by forming strong relationships with diverse and representative community members; (3) walk the talk by using critically reflexive processes built on shared values and equal power relations; (4) use pencils not pens to implement ensuring an iterative project process; (5) recognise all contributions and especially the value of lived experience and local knowledge; (6) journey at a pace that allows all to participate; and (7) listen twice, talk once to give priority to hearing quieter voices. These seven practices can be utilised by other collaborative initiatives to increase genuine and power‐shared participation. These participatory processes can make sure that collaborative projects respect local knowledge, indigenous culture, and respond iteratively to community needs. [ABSTRACT FROM AUTHOR]

Objective: The objective was to describe mental health service and psychotropic medicine use among a cohort of Aboriginal young people and quantify their relation to sociodemographic, family and health factors. Methods: In a prospective cohort study with data linkage, 892 Aboriginal children aged 0–17 years living in urban and regional areas of New South Wales, Australia, were included. We assessed mental health–related service use, paediatric service use and psychotropic medicine dispensing claims covered by the Australian Government Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme from July 2012 to June 2017. Results: Most children (71%) did not have a record of mental health service or psychotropic medication use. 18.7% had ⩾1 mental health–related service claim; 26.7% had ⩾1 paediatric service claim; and 20.3% had ⩾1 psychotropic medicine dispensing claim. General practitioner services were the most accessed mental health–related service (17.4%) and 12.7% had been dispensed attention-deficit hyperactivity disorder medicines. Child characteristics associated with treatment included emotional and behavioural problems (prevalence ratio: 1.97, 95% confidence interval = [1.46, 2.64] for mental health services; prevalence ratio: 2.87, 95% confidence interval = [2.07, 3.96] for medicines) and risky behaviour (prevalence ratio: 1.56, 95% confidence interval = [1.12, 2.16] for mental health services; prevalence ratio: 2.28, 95% confidence interval = [1.54, 3.37] for medicines). Parent-related factors included chronic illness (prevalence ratio: 1.42, 95% confidence interval = [1.03, 1.95] for mental health services; prevalence ratio: 2.00, 95% confidence interval = [1.49, 2.69] for medicines) and functional limitations (prevalence ratio: 1.61, 95% confidence interval = [1.16, 2.24] for mental health services; prevalence ratio: 1.86, 95% confidence interval = [1.34, 2.59] for medicines). Conclusions: Most Aboriginal children and young people did not have claims for mental health services or medicines. Aboriginal children with emotional and behavioural problems, or parents with health problems were more likely to have mental health service or medicine claims. [ABSTRACT FROM AUTHOR]

The text explores the formation of family and community doctors with a specific focus on acting in rural areas and the health of the indigenous population, a frequently neglected aspect in residency programs in large urban centers. The narrative details an internship at the Macapá Indigenous Health Support House (Casai) and at the base hub of the Manga village, located in Oiapoque, Amapá. During this internship, the resident doctor of the municipality of Rio de JaneiroRJ had the opportunity to provide medical attention directly to indigenous communities of the villages of Amapá and northern Pará. A central aspect of the text is the importance of exchange between scientific knowledge and traditional indigenous practices. The respect demonstrated by the indigenous population and the credibility attributed to their beliefs were essential to the effectiveness of the care performed. This experience offered the resident significant learning about person -centered medicine, allowing enriching contact with different cultures and traditions. These cultures have unique visions and understandings about the process of getting sick and healing, which contributed to a broader and more integrated understanding of health care. The internship stressed the importance of recognizing and respecting cultural practices in medical practice. [ABSTRACT FROM AUTHOR]

Background: Ethiopia is recognized as one of the centers of origin for the diversity of many plant species, including medicinal plants. Throughout the country, a large proportion of the population relies on these therapeutic plant species for primary healthcare. While such traditional medicinal knowledge has been documented in some regions, there is a lack of information from the Quara district of northwestern Ethiopia. Therefore, this study aimed to document the indigenous and local knowledge of the use of medicinal plants among three ethnic groups residing in the area. Methodology: An ethnobotanical study was conducted from August 2022 to October 2023 in ten kebeles of the Quara district. Data were collected through semi-structured interviews, field walks, and focus group discussions with 286 informants using snowball, purposive, and random sampling techniques. Quantitative analyses included Rahman's similarity index (RSI), informant consensus factor (ICF), and direct matrix ranking (DMR). Descriptive statistics were used to analyze basic ethnobotanical data. Results: A total of 128 medicinal plant species from 112 genera and 50 families were documented and used to treat 14 disease categories. There was a 28% overlap in medicinal plant knowledge among the three ethnic groups studied. Fabaceae was the most represented family with 22 species. Trees accounted for the majority of the documented plants (37.5%), and leaves were the most commonly used plant parts (23.1%). Oral administration (56.7%) of plant extracts was the primary mode of remedy preparation and use. The highest ICF value (0.93) was recorded for circulatory and blood-related disorders. The study identified nine plants and 39 therapeutic uses not previously reported in Ethiopia. The RSI showed high overlap with neighboring areas and low similarity with distant areas. Top-ranked multipurpose plants were Ziziphus spina-christi and Terminalia leiocarpa, with agricultural expansion and fuelwood collection identified as major threats. Conclusion: The findings demonstrate the rich diversity of medicinal plants and associated traditional knowledge in the Quara district. The high ethnobotanical indices warrant further phytochemical and pharmacological investigations. Integrated conservation efforts are recommended to address the challenges facing these valuable plant resources. [ABSTRACT FROM AUTHOR]

To gather knowledge and experiences from Squamish Nation citizens to codevelop a model of foraging walks for Indigenous women's heart health. Qualitative study (sharing circles). Vancouver, Canada (virtual). Squamish Nation community members (n = 9), Elders or Knowledge Keepers (n = 5), and researchers (n = 2). Community-led foraging walks as a culturally safe nutrition education strategy. Perspectives and experiences. Content analysis and narrative synthesis. Personal experiences of foraging walks or knowledge of traditional plants were limited for most participants, and all desired to learn more about traditional foods using land-based activities. Participants identified a lack of nutrition education surrounding heart health and common mistreatment and judgment from health professionals. Participants identified important elements of a future Squamish program, including who should be involved, how to implement it, and the most effective temporal and physical setting. All agreed foraging walks help promote 5 dimensions of heart health (physical, emotional, spiritual, mental, and social) through physical activity, purposeful nutrition, and connection to community and culture. Findings from the sharing circles were used in the creation of a template for future foraging sessions and contributed to plant identification cards for the whole community. Community-based pilot studies to test foraging walks as a culturally safe and environmental approach to nutrition education and cardiovascular health awareness for Indigenous communities are warranted. Research to examine the similarities and differences across Indigenous groups related to understanding heart health and land-based practices for nutrition education and heart health awareness is needed. [ABSTRACT FROM AUTHOR]

Background: Large datasets exist in Australia that make de-identified primary healthcare data extracted from clinical information systems available for research use. This study reviews these datasets for their capacity to provide insight into chronic disease care for Aboriginal and Torres Strait Islander peoples, and the extent to which the principles of Indigenous Data Sovereignty are reflected in data collection and governance arrangements. Methods: Datasets were included if they collect primary healthcare clinical information system data, collect data nationally, and capture Aboriginal and Torres Strait Islander peoples. We searched PubMed and the public Internet for data providers meeting the inclusion criteria. We developed a framework to assess data providers across domains, including representativeness, usability, data quality, adherence with Indigenous Data Sovereignty and their capacity to provide insights into chronic disease. Datasets were assessed against the framework based on email interviews and publicly available information. Results: We identified seven datasets. Only two datasets reported on chronic disease, collected data nationally and captured a substantial number of Aboriginal and Torres Strait Islander patients. No dataset was identified that captured a significant number of both mainstream general practice clinics and Aboriginal Community Controlled Health Organisations. Conclusions: It is critical that more accurate, comprehensive and culturally meaningful Aboriginal and Torres Strait Islander healthcare data are collected. These improvements must be guided by the principles of Indigenous Data Sovereignty and Governance. Validated and appropriate chronic disease indicators for Aboriginal and Torres Strait Islander peoples must be developed, including indicators of social and cultural determinants of health. Considerable data are collected on Aboriginal and Torres Strait Islander peoples, extracted from primary healthcare services. We reviewed these datasets for their capacity to provide insight into chronic disease care for Aboriginal and Torres Strait Islander peoples. Most data providers have the potential capability to capture detailed indicators across many chronic diseases. It is critical that more accurate, comprehensive, and culturally meaningful Aboriginal and Torres Strait Islander healthcare data are collected to support evidence-based policy. [ABSTRACT FROM AUTHOR]

Nutritional well-being of Indigenous Peoples is shaped by foodways through their relationship with culturally vital indigenous foods. An exploratory mixed- methods study was conducted among Ho community of Jharkhand to get an insight into their traditional foodways. Study sites included ten randomly selected villages from three geographically distant blocks of West Singhbhum, including Sonua, Khuntpani and Chakradharpur. Qualitative enquiries included focus group discussions and village transect walk interviews which captured diverse information including food access from natural sources, market access, livelihood sources, social and cultural norms around foods, environmental factors, hygiene and sanitation conditions, and community health. Seasonal market surveys (monsoon and winter) in ten local markets provided information on food diversity and local prices. The findings revealed that foodways of Ho community are based on foraging, hunting, and traditional farming through use of available ecosystem resources. However, their traditional foodways are under threats due to livelihood and nutrition transitions. They have unique food traditions and cultures, yet their meals lack variety in terms of the foods consumed. Their smallholder farming systems are not profitable, pushing them towards rural-to-urban migration. Thus, it is crucial to promote traditional foodways of Hos to support bio-cultural knowledge, food justice and nutrition in this community. [ABSTRACT FROM AUTHOR]

Background: The gaps in healthy life expectancy (HLE) between Indigenous and non-Indigenous Australians are significant. Detailed and accurate information is required to develop strategies that will close these health disparities. This paper aims to quantify and compare the causes and their relative contributions to the life expectancy (LE) gaps between the Indigenous and non-Indigenous population in the Northern Territory (NT), Australia. Methods: The age-cause decomposition was used to analyse the differences in HLE and unhealthy life expectancy (ULE), where LE = HLE + ULE. The data was sourced from the burden of disease and injury study in the NT between 2014 and 2018. Results: In 2014–2018, the HLE at birth in the NT Indigenous population was estimated at 43.3 years in males and 41.4 years in females, 26.5 and 33.5 years shorter than the non-Indigenous population. This gap approximately doubled the LE gap (14.0 years in males, 16.6 years in females) at birth. In contrast to LE and HLE, ULE at birth was longer in the Indigenous than non-Indigenous population. The leading causes of the ULE gap at birth were endocrine conditions (explaining 2.9–4.4 years, 23–26%), followed by mental conditions in males and musculoskeletal conditions in females (1.92 and 1.94 years, 15% and 12% respectively), markedly different from the causes of the LE gap (cardiovascular disease, cancers and unintentional injury). Conclusions: The ULE estimates offer valuable insights into the patterns of morbidity particularly useful in terms of primary and secondary prevention. [ABSTRACT FROM AUTHOR]

Cultural safety is increasingly recognised as imperative to delivering accessible and acceptable healthcare for First Nations Peoples within Australia and in similar colonised countries. A literature review undertaken to inform the inaugural Caring for Australians with Renal Insufficiency (CARI) guidelines for clinically and culturally safe kidney care for Aboriginal and Torres Strait Islander peoples revealed a timeline of the emergence of culturally safe kidney care in Australia. Thirty years ago, kidney care literature was purely biomedically focused, with culture, family and community viewed as potential barriers to patient 'compliance' with treatment. The importance of culturally informed care was increasingly recognised in the mid‐1990s, with cultural safety within kidney care specifically cited from 2014 onwards. The emergence timeline is discussed in this paper in relation to the five principles of cultural safety developed by Māori nurse Irihapeti Ramsden in Aotearoa/New Zealand. These principles are critical reflection, communication, minimising power differences, decolonisation and ensuring one does not demean or disempower. For the kidney care workforce, culturally safe care requires ongoing critical reflection, deep active listening skills, decolonising approaches and the eradication of institutional racism. Cultural safety is the key to truly working in partnership, increasing Indigenous Governance, respectful collaboration and redesigning kidney care. [ABSTRACT FROM AUTHOR]

The Gigii-Bapiimin study explored the impacts of the COVID-19 pandemic on the health and wellbeing of First Nations, Inuit, and Métis people living with HIV in Manitoba and Saskatchewan, two provinces in Canada with alarmingly high rates of HIV infections. Participants (n = 28 in Manitoba and n = 23 in Saskatchewan) were recruited using various methods, including flyers, community organizations, peers, and social media. The qualitative interviews focused on the pandemic's impact on health, access to services, and ceremonies. The data were analyzed using inductive thematic analysis. The study identified three key themes: (a) resilience and coping; (b) negative impacts on health and substance use; (c) decreased access to health services, HIV care and harm reduction. The participants shared their experiences of social isolation and the loss of community support, which had deleterious effects on their mental health and substance use. The impacts on access to HIV care were exacerbated by poverty, homelessness, and distress over inadvertent disclosure of HIV status. Participants mitigated these impacts by relying on Indigenous knowledges, ceremonies, and resilience within their communities. Service providers must address the impacts of the COVID-19 pandemic on Indigenous people living with HIV and their access to HIV services and ceremonies. [ABSTRACT FROM AUTHOR]

Background: Australia is struggling to meet its National Hepatitis B Strategy care targets, particularly in nonmetropolitan settings. It is vital to engage priority populations and improve their access to recommended care to reach these targets. Aims: This retrospective study examined people living with chronic hepatitis B (CHB) in regional North Queensland, Australia, and determined whether their care adhered to current national CHB management guidelines. The analysis aimed to identify gaps in care that might be addressed to improve future outcomes. Methods: All individuals referred to the gastroenterology clinic at the Townsville University Hospital in regional North Queensland, Australia, for CHB care between January 2015 and December 2020 were identified. Their linkage to care, engagement in care and receipt of guideline‐recommended CHB care were determined. Results: Of 255 individuals, 245 (96%) were linked to care; 108 (42%) remained engaged in care and 86 (38%) were receiving guideline‐recommended care in 2021. There were 91/255 (36%) who identified as Indigenous Australians. Indigenous status was the only independent predictor of not being linked to care (odds ratio (OR): 0.13 (95% confidence interval (CI): 0.03–0.60), P = 0.01), not being engaged in care (OR: 0.19 (95% CI: 0.10–0.36), P < 0.0001), not receiving guideline‐recommended CHB care (OR: 0.16 (95% CI: 0.08–0.31), P < 0.0001) or not being engaged in a hepatocellular carcinoma surveillance programme (OR: 0.08 (95% CI: 0.02–0.27), P < 0.0001). Conclusion: Current approaches are failing to deliver optimal CHB care to Indigenous Australians in regional North Queensland. Targeted strategies to ensure that Indigenous Australians in the region receive equitable care are urgently needed. [ABSTRACT FROM AUTHOR]

The aim was to investigate and analyze the social, health, and economic impact of the Covid-19 pandemic on Indigenous communities in the province of Catamarca (Argentina), while also identifying the various strategies developed by these communities to address this phenomenon. The research was conducted between December 2021 and December 2022, with an exploratory nature and a predominantly qualitative methodological design. During the fieldwork, 15 in-depth interviews were conducted with community authorities, community members, territorial technicians, and health workers, complemented by 30 structured interviews with individuals from different communities in the Santa María Department. Although tensions between the official health system and Indigenous communities (with their worldviews and ancestral practices) are evident, the importance of community self-management and territorial control over Indigenous organizational processes is also observed in health prevention and care actions, as well as in establishing dialogues and negotiations with local health authorities regarding the implementation of measures in the territories.

A correction is presented to the article "Food Insecurity and Its Association with Multiple Health Outcomes Among Indigenous Peoples in Canada: The Buffering Role of Culture-Based Resources" published in a previous issue of the periodical.

Introduction: Sleep is vital for health in older adulthood. Ethnic disparities have been noted with regards to sleep health. However, culturally appropriate approaches to sleep as a broader social experience are lacking. Methods: Here, sleep-related group interviews were conducted in the form of hui (group meetings and discussions) with eleven participants of a health service intervention for older Māori (the Indigenous people of New Zealand) and their whanau (extended family). Notes were collated and analyzed thematically. Results: Four key themes were constructed that represent the key conversations and ideas. These concerned the conceptualizing of sleep--including appreciation for its somatic role but also the spiritual properties of sleep states; the changing obligations around sleep and wake--including individual and communal time use and changing cultural and familial obligations with advancing age; and the barriers and facilitators for supporting sleep--including the social and spiritual nature of communal sleeping, the schedules and sleep of others, as well as holistic and environmental methods for relaxation. Findings demonstrate themultifaceted nature of sleep and aging among Māori. Culturally relevant interpretations of sleep practices and disturbances were offered and are beyond typical Western models which are predominantly medicalized. Discussion: This work aids the understanding and representation of sleep as a social and cultural perspective within the New Zealand context. This provides foundations for future participatory research to design culturally appropriate approaches to assessing and supporting sleep health in forms that aremeaningful for aging well across cultures. [ABSTRACT FROM AUTHOR]

The Pacific population in Aotearoa New Zealand is youthful, with the majority (55%) being under the age of 25 (Statistics New Zealand, 2014). It is vital that youth mental health for Pacific is understood in relation to their overall wellbeing (Paterson et al., 2018). In parallel to this, the World Health Organization (2022) accentuates the need to protect and promote mental wellbeing for young people globally. Specifically, Pacific youth were far more likely than Aotearoa New Zealand European counterparts to have poorer mental health and higher numbers of suicidality and self-harming behaviours (Ataera-Minster & Trowland, 2018; Fa'alili-Fidow et al., 2016). Moreover, research confirms that Pacific people aged 15–24 years have higher levels of psychological distress of 38% compared to 35% of Pacific adults aged 45–64 years (Ataera-Minster & Trowland, 2018). There is a lack of evidence-based psychological approaches that are culturally appropriate and applicable for Pacific people in Aotearoa New Zealand. Considerably, substantial evidence supports the need to provide more accessible resources and interventions that are flexible, culturally adaptable and cost-effective for Pacific youth. This review aims to (1) provide an insight into Pacific people in Aotearoa New Zealand, (2) have an understanding of Pacific worldview & wellbeing, (3) highlight mental health for Aotearoa New Zealand youth & globally (4) identify therapeutic approaches, including digital mental health globally and in Aotearoa New Zealand. Understanding the perspectives of Pacific youth is a significant first step. Therefore, this article will examine the therapeutic approaches, specifically in the digital space, that are proven effective when promoting wellness for Pacific youth. [ABSTRACT FROM AUTHOR]

American Indians suffer from disproportionately high rates of mental health problems. Professional therapies may not meet the specific mental health needs of American Indians, owing to cultural mismatch and long histories of political disempowerment. Instead, Indigenous traditional spiritual practices are often promoted as alternative sources of health and help in these communities. In response to a community needs assessment, we developed a 12-week traditional spirituality curriculum in partnership with the urban American Indian health clinic in Detroit. Centered on the sweat lodge ceremony, the program was pilot tested with 10 community members. Semi-structured interviews were conducted with nine participants following the program. Based on our analyses, all participants endorsed responses within two overarching themes: impact on personal well-being, and suggestions for improvement reflecting their desire for an ongoing program. Participant responses about the program's impact comprised four themes: (1) improved psychological and spiritual well-being, (2) community benefit, (3) increase in cultural knowledge, and (4) a desire for further learning and sharing. Participant responses about their desire for an ongoing program also comprised four themes: (1) drop-in classes may be more practical as regular attendance was difficult for some, (2) future classes should include more areas of knowledge, (3) the program could be expanded to include more knowledge-holders and perspectives, and (4) the program should include a progression of classes to accommodate more diversity. Overall, participants reported benefit from participation in Indigenous spiritual practices; however, the program can be improved by further adapting the curriculum to the sometimes-challenging lives of its participants. [ABSTRACT FROM AUTHOR]

By imposing non-Inuit ways of doing within households and communities, colonization has created a rift between generations and impacted the transmission of Inuit practices and knowledge. Inuit care-providers continue to support their fellow community members with individual and collective approaches to wellbeing. The objectives and design of the current project were developed with community members who play an active role in mobilization and wellness. Inuit and non-Inuit research assistants conducted 14 individual interviews and 2 group interviews (total of 19 participants) with key informants involved in community wellness work. Then an Elder (third author) shared her knowledge regarding traditional practices. In this study we describe three underlying principles regarding wellness practices as well as five approaches and the mechanisms by which these approaches seem to impact personal and collective wellbeing. This study highlights how Inuit culture and knowledge can support children, family and community wellbeing in the ways of being together and of taking care of each other. The study responds to an expressed desire named by our partners to document Inuit approaches as well as the principles and practices underlying such approaches and how they are related to self-determination. [ABSTRACT FROM AUTHOR]

We aimed to determine the variations in the prevalence of childhood anemia according to the ethnic group before and during the COVID-19 pandemic in Peru. Secondary analysis of the Demographic and Family Health Survey during 2016–2021. The outcome variable was anemia, and the exposure variable was maternal ethnicity. Also, we included sociodemographic and clinical confounding variables. We constructed generalized linear models of the Poisson family with a logarithmic link function. We evaluated 85,905 records; 30.34% had anemia, 50.83% were mestizo, 25.98% were Quechua, and 2% were Aymara. Compared with mestizos, Quechua children (PR: 1.11; 95% CI: 1.07–1.15; p < 0.001), Aymara (PR: 1.35; 95% CI: 1.27–1.44; p < 0.001), natives of the Amazon (PR: 1.20; 95% CI: 1.12–1.28; p < 0.001) and those who belonged to other indigenous peoples (PR: 1.29; 95% CI: 1.05–1.57; p = 0.013) had a higher prevalence of childhood anemia. On the contrary, compared to mestizos, white children had a lower prevalence of anemia (PR: 0.93; 95% CI: 0.89–0.99; p = 0.019). During the COVID-19 pandemic, compared to mestizos, only Quechua (PR: 1.15; 95% CI: 1.08–1.23; p < 0.001) and Aymara (PR: 1.38; 95% CI: 1.23–1.55; p < 0.001) had a higher prevalence of childhood anemia. Except for Afro-descendants, children from 6 to 59 months of age who belong to an ethnic minority had a higher probability of having childhood anemia than mestizos. However, only Quechua and Aymara children had higher odds of anemia during the COVID-19 pandemic than mestizos. [ABSTRACT FROM AUTHOR]

Introduction. From a coronavirus disease (COVID-19) pandemic perspective, Aotearoa New Zealand (NZ) rural residents formed an at-risk population, and disparities between rural and urban COVID-19 vaccination coverage have been found. Aim. To gain insight into factors contributing to the urban-rural COVID-19 vaccination disparity by exploring NZ rural health providers' experiences of the vaccine rollout and pandemic response in rural Māori and Pasifika communities. Methods. Rural health providers at four sites participated in individual or focus group semi-structured interviews exploring their views of the COVID-19 vaccine rollout. Thematic analysis was undertaken using a framework-guided rapid analysis method. Results. Twenty interviews with 42 participants were conducted. Five themes were identified: Pre COVID-19 rural situation, fragile yet resilient; Centrally imposed structures, policies and solutions - urban-centric and Pakehā focused; Multiple logistical challenges - poor/no consideration of rural context in planning stages resulting in wasted resource and time; Taking ownership - rural providers found geographically tailored, culturally anchored and locally driven solutions; Future directions - sustained investment in rural health services, including funding long-term integrated (rather than 'by activity') health services, would ensure success in future vaccine rollouts and other health initiatives for rural communities. Discussion. In providing rural health provider perspectives from rural areas serving Māori and Pasifika communities during the NZ COVID-19 vaccine rollout, the importance of the rural context is highlighted. Findings provide a platform on which to build further research regarding models of rural health care to ensure services are designed for rural NZ contexts and capable of meeting the needs of diverse rural communities. [ABSTRACT FROM AUTHOR]

Background. Cardiovascular disease is a major health issue for Māori that requires timely and effective first-response care. Māori report culturally unsafe experiences in health care, resulting in poor health outcomes. Research in the pre-hospital context is lacking. This study aimed to explore experiences of cultural (un)safety for Māori and their whānau who received acute pre-hospital cardiovascular care from paramedics. Methods. Utilising a qualitative descriptive methodology and Kaupapa Māori Research (KMR), in-depth semi-structured interviews were undertaken with 10 Māori patients and/or whānau, and a general inductive approach was used for analysis. Results. Three key themes were identified: (1) interpersonal workforce skills, (2) access and service factors and (3) active protection of Māori. Participants described paramedics' clinical knowledge and interpersonal skills, including appropriate communication and ability to connect. Barriers to accessing ambulance services included limited personal and community resources and workforce issues. The impact of heart health on communities and desire for better preventative care highlighted the role of ambulance services in heart health. Conclusion. Māori experience culturally unsafe pre-hospital care. Systemic and structural barriers were found to be harmful despite there being fewer reports of interpersonal discrimination than in previous research. Efforts to address workforce representation, resource disparities and cultural safety education (focussing on communication, partnership and connection) are warranted to improve experiences and outcomes for Māori. [ABSTRACT FROM AUTHOR]

The article explores regenerative agriculture's evolution and definitions, emphasizing its transformation from traditional farming methods to holistic practices that enhance ecological, social, and economic outcomes. It also discusses the integration of medicinal and aromatic plants into regenerative agriculture systems, highlighting their roles in soil health improvement, biodiversity conservation, and economic diversification.

Objective: To describe the frequency and observed trends for all Indian Health Service (IHS) and tribal emergency department (ED) transfers to a pediatric referral center from January 1, 2017, to December 31, 2020, with a secondary analysis to describe trends in final dispositions, lengths of stay (LOS), and the most common primary ICD‐10 diagnoses. Methods: We performed a retrospective chart review of IHS and tribal ED transfers to a pediatric referral center from 2017 to 2020 (n = 2433). The data were summarized using frequencies and percentages and we used generalized estimating equations to analyze patient characteristics over time. Results: IHS and tribal ED transfers accounted for 6.5%–7.1% of all transfers each year between 2017 and 2020 without significant changes over time. Within this group, 60% were admitted and 62% experienced a LOS greater than 24 h. The most common diagnostic code groups for these patients were respiratory conditions, injuries and poisonings, nonspecific abnormal clinical findings and labs, digestive system diseases, and nervous system diseases. Conclusions: This study addresses important knowledge gaps regarding transfers from IHS and tribal EDs, highlights potential high‐impact areas for pediatric readiness, and emphasizes the need for more granular data to inform resource allocation and educational interventions. Further studies are needed to delineate potentially avoidable transfers seen within this population. [ABSTRACT FROM AUTHOR]

Background: Indigenous and non-indigenous people in subtropical and temperate areas of Bhutan share an intricate relationship with stingless bees for diverse purposes including ethno-medicinal uses. Stingless bees hold significant importance in the realms of social, economic, cultural, and spiritual aspects. Bhutan's cultural traditions demonstrate a strong bond with the environment, exemplified by the regular use of honey from stingless bees for remedies such as treating the common cold, cough, and sore throat. Methods: Ethnographic research was conducted to document the ethno-medicinal uses and cultural importance of stingless bees in Bhutan. We deployed semi-structured interviews with stingless beekeepers and honey collectors including traditional healers who perform religious rituals for curing and preventing physical and mental illness. Results: We documented 22 different uses of stingless bee honey in food, medicine, veterinary medicine, crafts, beliefs, and religious purposes. The relative cultural importance (RCI) of stingless bees among Bhutan's ethnic communities was assessed through our calculations. It was determined that these bees hold notably greater significance for the Lhotshampa communities compared to other ethnic groups in Bhutan. This finding demonstrates the dependence of Hindu ethnic communities on natural resources in their everyday life. All participant communities largely exploit these bees through destructive extraction practices. They often find the natural nests in nearby forests, transfer them as a log hive to their backyards, and practice traditional meliponiculture. Conclusion: The ethnic communities of Bhutan use stingless bees for various purposes and the local knowledge are persistent. However, significant efforts should be made to address the ethno-medicinal, ecological, biological, and commercial perspectives of meliponiculture in Bhutan. [ABSTRACT FROM AUTHOR]

The article describes Indigenous Community-Based Participatory Research (ICBPR) and provides an example of how it was utilized in the Project Safe-Schools (PSS) study. Topics discussed include examples of ICBPR in the PSS study, diversity within and across indigenous tribes, and cultural keepers of knowledge and strengths.

Introduction: The COVID-19 pandemic continues to plague the world, but there are indigenous communities that have adopted various protection measures in their homes and communities. Objective: Describe cultural practices to prevent COVID-19 in an indigenous community in Peru, 2021. Method: Descriptive qualitative research. The sampling was non-probabilistic for convenience, 08 mothers and 02 fathers from the Supayacu native community participated in the study. For data collection, four interviews were applied via Zoom and six in person with prior informed consent. Data were analyzed using thematic content analysis. Results: Four categories emerged: a) Communal organization: Closure of borders, process of acquisition and disinfection of provisions, b) Cultural care in food and use of traditional medicine, c) Adoption of preventive measures: Washing hands, use of masks, alcohol, hygiene of the home, d) Religious beliefs and rituals: divine punishment, fasting and prayer. Conclusions: This indigenous community used their ancestral knowledge and cultural practices to protect themselves from COVID-19, based on their organization, the closure of borders, the use of medicinal plants, and their religious beliefs. In addition, they complied with preventive measures such as hand washing, use of masks, alcohol, and social distancing. [ABSTRACT FROM AUTHOR]

At Te Kunenga ki Pūrehuroa (Massey University), Aotearoa New Zealand, we have declared our stance as a Te Tiriti o Waitangi-led institution. This necessitates the embodiment and enactment of the principles and provisions of Te Tiriti o Waitangi and the embedding of Indigenous Māori knowledge, values and belief systems in curriculum design and implementation. This article outlines the beginning of our journey toward indigenizing our postgraduate public health curriculum at Te Kunenga ki Pūrehuroa. We describe the redevelopment of the Master of Public Health curriculum that embeds mātauranga Māori (Māori knowledge), te reo Māori (Māori language), tikanga Māori (Māori values and belief systems), and Māori pedagogy (culturally sustaining teaching and learning practices). Here, we focus on how curriculum redevelopment and pedagogy have enabled the utility of Māori knowledge and processes to be reflected at every level of the program and give life and relevancy to Te Tiriti o Waitangi. Te Tiriti o Waitangi guides our teaching practice and ensures that students can safely develop their confidence in Māori ways of knowing, being, and doing to effectively partner with Māori as Tangata Whenua. Our program aims to produce agentic graduates who are champions and advocates for Māori aspirations in health. [ABSTRACT FROM AUTHOR]

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Standard harm reduction approaches to alcohol and other drug harms do not adequately meet Indigenous needs or preferences for reducing risks or improving quality of life. In this article we identify and discuss important components of an Indigenous-centred harm reduction approach to alcohol and other drug-use concerns that are evident in the literature. Four critical components of an Indigenous approach to harm reduction are: 1) Whakapapa: Substance use harm reduction must consider the history and relationships between culture and community-specific harms, particularly colonisation and intergenerational trauma; 2) Huanui oranga: Incorporating the strengths, preferences, and strategies of Indigenous communities must be included to accurately and effectively respond to substance related harms; 3) Mauri ora, Whānau ora and Wai ora: Harm reduction efforts must seek to increase quality of life as defined by Indigenous communities; and 4) Ngā take pū o te tangata: Harm reduction must be guided by the values and principles of Indigenous peoples. This article describes an Indigenous, traumainformed harm reduction approach, Pae Tata Pae Tawhiti that incorporates a well-known Māori model of health, Te Whare Tapa Whā to centre Māori concepts of wellbeing. We include an overview of intergenerational trauma and introduce TAWHITI, a set of Indigenous trauma-informed harm reduction principles for Māori. Finally, describing a workforce development model that supports the application and future evaluation of the Pae Tata Pae Tawhiti framework. [ABSTRACT FROM AUTHOR]

Introduction: Health research that focuses on Indigenous Peoples must ensure that the community in question is actively engaged, and that the results have context relevance for Indigenous Peoples. Context relevance is "the benefits, usability, and respectful conduct of research from the perspective of Indigenous communities." The purpose of this study was to apply two tools within an already-published scoping review of 76 articles featuring research on cognitive impairment and dementia among Indigenous Peoples worldwide. One tool assessed levels of community engagement reported in the corpus, and the other tool assessed the context relevance of recommendations in the corpus. We hypothesized that research with higher levels of reported community engagement would produce recommendations with greater context relevance for Indigenous Peoples. Methods: We employed semi-structured deductive coding using two novel tools assessing levels of reported community engagement and context relevance of recommendations based on studies included in the existing scoping review. Results: Application of the two tools revealed a positive relationship between increasing community engagement and greater context relevance. Community engagement primarily occurred in studies conducted with First Nations, Inuit, and Métis populations in Canada and with Australian Aboriginal and/or Torres Strait Islander Peoples. Research with Alaska Native, American Indian, and Native Hawaiian Peoples in the USA stood out for its comparative lack of meaningful community engagement. Discussion: There is opportunity to utilize these tools, and the results of this assessment, to enhance training and mentorship for researchers who work with Indigenous populations. There is a need to increase investigator capacity to involve communities throughout all phases of research, particularly in the pre-research stages. [ABSTRACT FROM AUTHOR]

Background: Indigenous patients often present with complex health needs in clinical settings due to factors rooted in a legacy of colonization. Healthcare systems and providers are not equipped to identify the underlying causes nor enact solutions for this complexity. This study aimed to develop an Indigenous-centered patient complexity assessment framework for urban Indigenous patients in Canada. Methods: A multi-phased approach was used which was initiated with a review of literature surrounding complexity, followed by interviews with Indigenous patients to embed their lived experiences of complexity, and concluded with a modified e-Delphi consensus building process with a panel of 14 healthcare experts within the field of Indigenous health to identify the domains and concepts contributing to health complexity for inclusion in an Indigenous-centered patient complexity assessment framework. This study details the final phase of the research. Results: A total of 27 concepts spanning 9 domains, including those from biological, social, health literacy, psychological, functioning, healthcare access, adverse life experiences, resilience and culture, and healthcare violence domains were included in the final version of the Indigenous-centered patient complexity assessment framework. Conclusions: The proposed framework outlines critical components that indicate the presence of health complexity among Indigenous patients. The framework serves as a source of reference for healthcare providers to inform their delivery of care with Indigenous patients. This framework will advance scholarship in patient complexity assessment tools through the addition of domains not commonly seen, as well as extending the application of these tools to potentially mitigate racism experienced by underserved populations such as Indigenous peoples. [ABSTRACT FROM AUTHOR]

Background: Liver disease is an important contributor to the mortality gap between First Nations Peoples and non-Indigenous Australian adults. Despite a high burden of metabolic comorbidities among First Nations Peoples, data about the epidemiology of metabolic dysfunction-associated steatotic liver disease (MASLD) in this population is scarce. Methods: A retrospective analysis of all adults hospitalized with MASLD or metabolic dysfunction-associated steatohepatitis (MASH) with/without cirrhosis during 2007–2019 in the state of Queensland was performed. Patients were followed from the first admission with MASLD/MASH (identified based on validated algorithms) to decompensated cirrhosis and overall mortality. We explored differences according to Indigenous status using Multivariable Cox regression. Findings: 439 First Nations Peoples and 7,547 non-Indigenous Australians were followed for a median of 4.6 years (interquartile range 2.7–7.2). Overall, women were overrepresented, but more so in the First Nations cohort (72.7% vs. 57.0%, p < 0.001). First Nations patients were younger, a higher proportion lived in remote and socioeconomic disadvantaged areas, and had higher comorbidity compared to non-Indigenous Australians (all p < 0.001). Diabetes, the most common comorbidity affecting both groups, was overrepresented in First Nations Peoples versus non-Indigenous Australians (43.5% vs. 30.8%, p < 0.001, respectively). Nineteen (4.3%) First Nations Peoples and 332 (4.4%) of non-Indigenous patients progressed to cirrhosis decompensation (9.0% [95%CI 4.5–17.7] vs. 7.7% [95%CI 6.6–8.9; p = 0.956] respectively within 10 years). In multivariable analysis, there was no association between Indigenous status and progression to decompensated cirrhosis (p = 0.759) and survival (p = 0.437). Conclusions: This study provides the first population-based epidemiological data on MASLD in First Nations Australians. The high prevalence of diabetes (that is associated with advanced fibrosis and liver disease mortality) among young First Nations Peoples with MASLD raises concern about future risk of progressive liver disease in this patient population. These data highlight the importance of early identification of MASLD, and providing culturally appropriate intervention to reduce disease progression in parallel with the management of cardiometabolic comorbidities. [ABSTRACT FROM AUTHOR]

Stunting affects almost one‐quarter of children globally, leading to reduced human capacity and increased long‐term risk of chronic disease. Despite intensive infant and young child feeding (IYCF) interventions, many children do not meet their requirements for essential nutrients. This study aimed to assess the feasibility of implementing an IYCF intervention utilizing nutrient‐dense powders from egg, biofortified sugar beans and Moringa oleifera leaf in rural Zimbabwe. A mixed‐methods formative study was conducted comprising the following: (i) a recipe formulation trial, (ii) trials of improved practices to assess acceptability of the intervention, and (iii) a participatory message formulation process to develop counselling modules for the IYCF‐plus intervention. Twenty‐seven mother–baby pairs were recruited between November 2019 and April 2020. Key domains affecting IYCF practices that emerged were time, emotional and physical space, cultural and religious beliefs, indigenous knowledge systems and gender dynamics. Household observations and sensory evaluation indicated high acceptability of the new ingredients. Recipe formulation and participatory message formulation by participants instilled community ownership and served to demystify existing misconceptions about the new food products. Families noted the potential for intervention sustainability because the foods could be grown locally. Supplementing complementary foods with nutrient‐dense local food ingredients as powders has the potential to sustainably address nutrient‐gaps in the diets of young children living in rural lower‐ and middle‐income countries. Comprehensive IYCF counselling utilizing a gender‐lens approach, family support and indigenous knowledge systems or resources are key elements to support positive behaviour change in complementary feeding interventions. Key messages: Incorporating locally available solid foods into complementary feeding is a major challenge for caregivers in rural communities. There are several barriers that hinder mothers from feeding nutrient‐dense solid foods such as animal source foods, fruits and vegetables, resulting in nondiversified complementary diets.Formulation of nutrient‐dense, high‐quality protein complementary meals using powdered locally available food supplements is feasible, well tolerated and allows young children to be fed nutrient‐dense complementary meals in rural LMICs.Utilizing traditionally recognized functional foods such as Moringa olifeira encourages the involvement of elderly women/grandmothers in infant and young child feeding, enabling support for mothers.Integrated complementary feeding interventions incorporating behaviour change communication, provision/promotion of specific nutrient‐dense complementary foods (SQ‐LNS and local foods as powdered supplements), family support and agricultural production has potential for success in rural settings. [ABSTRACT FROM AUTHOR]

Environmental changes are affecting human health. A renewal of the way we understand and relate to the planet is needed. Ecospirituality brings together the terms spirituality and environment and is born as a means of solution to this dilemma. This systematic review aimed to find out the influence of ecospirituality on global health. A search of scientific literature was carried out in the main health science databases. A review was conducted to critically evaluate the studies that identified relevant ecospiritual aspects regarding health care for communities. After a systematic search and screening, and following specified methodological criteria, a total of 14 articles were selected in the review. The findings of the review suggest that a new perspective in our worldview such as ecospirituality will provide us with the necessary keys to improve health. To understand ecospirituality, we must keep in mind the indigenous way of life, which is the clear example to follow to achieve environmental health and global health. Ecospirituality leads to a healthier environment, and as this is directly related to health, there is also an improvement in global health. [ABSTRACT FROM AUTHOR]

Few men who experience a common mental disorder access any mental healthcare from a health professional. E-mental health (eMH; online) interventions may facilitate men's access to mental healthcare and reduce inequities in access via assistance in a format that aligns with their preferences and needs. Recent reviews show that men who have used these programmes generally find them useful and satisfactory; however, data on their effectiveness and factors impacting effectiveness in men's use are limited. Few eMH interventions have been designed specifically to suit men's preferences and circumstances, and little is known about the eMH-related experiences and needs of men from vulnerable and marginalized backgrounds. Despite their potential, Australian men's health, digital mental health, preventive health, and Aboriginal and Torres Strait Islander mental health and social and emotional well-being policies—and men's health policies from Malaysia, Ireland, and South Africa—make no specific mention to progressing the use or evaluation of eMH for men. We present a series of policy recommendations, aiming to improve men's access to effective and acceptable mental health assistance via eMH and increase health professional confidence to recommend and support these programmes. These include (i) the need for specific, connected health policy actions and targeted funding; (ii) policy priorities for intervention development, dissemination and evaluation; and (iii) for the experiences of men, particularly those from marginalized and vulnerable backgrounds, to be centred in policy. eMH for men should be promoted alongside interventions to reduce systems and social-level determinants of men's mental health inequities. [ABSTRACT FROM AUTHOR]

Health services research is underpinned by partnerships between researchers and health services. Partnership-based research is increasingly needed to deal with the uncertainty of global pandemics, climate change induced severe weather events, and other disruptions. To date there is very little data on what has happened to health services research during the COVID-19 pandemic. This paper describes the establishment of an Australian multistate Decolonising Practice research project and charts its adaptation in the face of disruptions. The project used cooperative inquiry method, where partner health services contribute as coresearchers. When the COVID-19 pandemic hit, data collection needed to be immediately paused, and when restrictions started to lift, all research plans had to be renegotiated with services. Adapting the research surfaced health service, university, and staffing considerations. Our experience suggests that cooperative inquiry was invaluable in successfully navigating this uncertainty and negotiating the continuance of the research. Flexible, participatory methods such as cooperative inquiry will continue to be vital for successful health services research predicated on partnerships between researchers and health services into the future. They are also crucial for understanding local context and health services priorities and ways of working, and for decolonising Indigenous health research. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs), or heart diseases, are the leading cause of morbidity and mortality nationwide. Separate bodies of research indicate that Lesbian, Gay, and Bisexual (LGB) individuals and Black, Indigenous, and People of Color (BIPOC) demonstrate high risk for CVD and report greater levels of intersectional microaggressions compared with their Heterosexual White and BIPOC counterparts. Within LGB communities, Bisexual individuals report more discrimination that is associated with more CVD risk factors compared with their Heterosexual and Lesbian and Gay (LG) counterparts. Research has not examined differences in the rates of CVD risk factors between Bisexual and LG BIPOC or the associations between intersectional microaggressions and heart disease risk perception in LGB BIPOC, a relevant construct correlated with health behavior and objective risk. Participants (N = 264) self-identified as LGB BIPOC and filled out measures on their CVD risk factors, CVD risk perception, and experiences of intersectional microaggressions or intersectional minority stress. Results showed that Bisexual and LG BIPOC reported similar odds for CVD risk factors. Intersectional minority stress and CVD risk perception were positively associated with Bisexual participants only. Findings underscore the importance of extending beyond traditional biomedical frameworks of CVD risk and recognizing the unique contribution of intersectional microaggressions for LGB BIPOC, with strong associations of intersectional minority stress for Bisexual BIPOC heart health. [ABSTRACT FROM AUTHOR]

Two-Spirit and lesbian, gay, bisexual, transgender, queer, and gender-diverse (2SLGBTQ+) adolescents and young adults (AYA) in Indigenous communities face disparate physical and mental health outcomes in the absence of connection to culture and Indigenous identity. There are limited data on the unique needs and strengths of this population. This work aimed to highlight the barriers and needs of 2SLGBTQ+ AYA and the link between cultural connection, pride, and resilience and positive health outcomes for these adolescents. This analysis of 15-25-year-old participants is derived from a mixed-methods study, which assessed the barriers to seeking and accessing care for 2SLGBTQ+ individuals. Survey and short-answer responses were collected through REDCap, and an analysis was performed using SAS 9.4 (quantitative) and ATLAS.ti (qualitative short answer). Responses demonstrate high levels of pride and connectedness among 2SLGBTQ+ AYA and that affirming healthcare is critical in supporting positive outcomes. Results also suggest a need for increased education regarding Indigenous worldviews, health, barriers to care, and historical contexts besides gender diversity. In conclusion, results indicate that pride and connection are inherent in 2SLGBTQ+ AYA communities, which can serve as protective factors to improve health outcomes. Using this knowledge, providers can support youth clinically as well as through policy and advocacy action. Family, community, and health provider support allow for identity formation and expression. Findings can also be applied to gender-diverse AYA in non-Indigenous communities. [ABSTRACT FROM AUTHOR]

Providing culturally safe speech-language pathology services to Aboriginal and Torres Strait Islander peoples with acquired communication disorders (ACDs) may be challenging for non-Indigenous speech-language pathologists (SLPs). Indigenous Health Liaison Officers (IHLOs) may share common histories and culture with patients, and provide valuable insights about cultural safety. The study aim was to explore IHLOs' experiences of working with Aboriginal and Torres Strait Islander adults post-stroke or traumatic brain injury (TBI), and with the SLPs who provide services to these peoples. Using an interpretive description collaborative research design informed by culturally responsive principles, IHLOs (n = 7) participated in interviews facilitated by Aboriginal researchers and the principal investigator. Data were analysed using qualitative content analysis, informed by perspectives of Aboriginal researchers. Two themes, Connection and Spirit and Emotion, and six interdependent categories described how Aboriginal and Torres Strait Islander peoples have, and need, strong connections to family, country, health professionals, and ACD practices. Without these connections, patients' wellbeing may be deeply affected. SLPs must collaborate with IHLOs and patients' family members and draw on their cultural knowledge, expertise, and guidance when working with Aboriginal and Torres Strait Islander peoples and ensure connections are created. These connections contribute to culturally safe and responsive speech-language pathology practice. [ABSTRACT FROM AUTHOR]