Search

Objectives: We investigate some of the strengths and challenges associated with Covid-19 responses in urban Indigenous communities in Brisbane, Australia. Our research reflects on the interconnected dynamics that impact health outcomes and mitigate or exacerbate the risk of Covid-19 spreading within urban Indigenous communities., Methods: Three systems thinking workshops were held in 2021 with Indigenous and non-Indigenous stakeholders (N15/workshop) from State and Federal services, along with Aboriginal Community Controlled Health Organisations. All worked in the urban Indigenous health sector. Stakeholders produced a Causal Loop Diagram (CLD) incorporating the critical feedbacks determining the dynamics influencing health outcomes. The aim of the research was to help stakeholders' build awareness of how the structure of the system influences health outcomes., Results: Stakeholders identified 6 key dynamics which have a negative or positive impact on mitigating risks of Covid-19 infection. By mapping these dynamics within a CLD, 7 intervention points were identified., Conclusions: Systems thinking provides a useful tool in identifying the complexities associated with navigating health challenges, but further research is needed to develop frameworks that work in conjunction with Indigenous Australian methodologies., Implications for Public Health: Indigenous voices and communities must lie central to health responses/policies for Indigenous peoples. When systems thinking is done by or in collaboration with stakeholders it provides a visual language that can help design public health policy. What can be ascertained is that their effectiveness is predicated on systems thinking's integration with Indigenous methodologies that acknowledges Indigenous self-determination and challenges Eurocentric representations of health and Indigeneity., Competing Interests: Conflict of interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Bronwyn Fredericks reports financial support was provided by Australian Partnership for Preparedness Research on Infectious Disease Emergencies., (Copyright © 2023. Published by Elsevier B.V.)

In this paper, we discuss a rapid‐fire study involving Indigenous and non‐Indigenous stakeholders from the urban Indigenous health sector who collaborated to produce an "Urban COVID‐19 Systems Map." The map outlines the behaviours, actions and responses that stakeholders identified as mitigating or exacerbating COVID‐19 risks in urban Indigenous communities. Data were collected and analysed during the height of the pandemic in 2021. We begin by introducing the characteristics of system thinking—the methodology that informed our research—and consider its use in Indigenous health research more broadly. We then outline our utilisation of system thinking and discuss how it was applied to the three workshops. System thinking contributes to collaboration and collective debate amongst stakeholders and aims to produce holistic understandings of complex problems, such as pandemics. This article provides a reflective overview of the benefits and challenges of applying system thinking in Indigenous health research whilst also sharing some of the research findings. We argue that centralising the voices of stakeholders, particularly Indigenous stakeholders, is critical to developing and implementing effective and culturally appropriate responses to pandemics and is equally as important to the preparedness for future pandemics. [ABSTRACT FROM AUTHOR]