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Background: Globally, an estimated 370 million Indigenous peoples reside in more than 70 countries with these people commonly experiencing health care access inequity. Purpose: This systematic review aimed to examine the impact of Indigenous health care curriculum on entry-level health professional learners in preparation to deliver equitable health care. Methods: Seventeen articles were identified and analyzed for: context; study design; study measures, teaching and learning delivery mode, content and duration; positive and negative learner reactions; learning gained and article quality was assessed using the Medical Education Research Study Quality Instrument. Results: Most included studies described face-to-face delivery along with blended learning combining a placement in an Indigenous setting, stand-alone placements and digital learning. Descriptions of learning gained covered five domains: remembering, understanding, self-knowledge, perspective and application relating mostly to cultural awareness. Factors contributing to positive learner reactions included attitude, environment, educator skill, pedagogy and opportunities. Factors contributing to negative learner reactions included attitude and environment. Conclusions: There is a need to further explore how health professional graduates are prepared to work in Indigenous health and the appropriate measures to do this. There is opportunity to learn more about Indigenous health teaching and learning across learning domains, in mainstream clinical placements and in digital learning. [ABSTRACT FROM AUTHOR]

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 Australia's 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. [ABSTRACT FROM AUTHOR]