Id Identify fying Wellbeing and Quality of Lif ife Dim imensions - - PowerPoint PPT Presentation

What Matters? Id Identify fying Wellbeing and Quality of Lif ife Dim imensions for Aboriginal and Torres Strait Is Isla lander people

Butler, T1, Anderson, K1, Garvey, G1, Cunningham, J1, Ratcliffe, J2, Tong, A3, Whop, L1,Cass, A1, Howard, K3

1 Menzies School of Health Research, Charles Darwin University, Australia 2 School of Business, University of South Australia, Adelaide, Australia 3 School of Public Health, University of Sydney, Sydney, Australia

tamara.butler@menzies.edu.au @tamarabutler

Acknowledgement

We acknowledge the Gadigal people of the Eora nation as custodians of the land on which we meet today and pay our respects to Elders, past, present, and emerging. We acknowledge the Aboriginal and Torres Strait Islander people present today.

Background & Aim

• Indigenous Australians’ understandings of health and wellbeing differ

from those of other Australians.

• Wellbeing is viewed as holistic, multi-dimensional, and often

contingent on not only individual’s wellbeing but their community’s wellbeing.

• Conventional PROMs may not capture wellbeing domains relevant to

Indigenous Australians

• Limits the ability for measures to provide a culturally appropriate

assessment of patient outcomes Aim To identify wellbeing domains relevant to Indigenous Australians

• Articles that focused on Aboriginal and/or Torres Strait Islander adults

and described at least one identifiable dimension/domain of wellbeing in general (non-disease specific) settings.

• Wide range of articles were included

Method

Search, Selection and Data Extraction

Academic databases, grey literature, handsearch, Google Scholar Search terms relating to “Indigenous Australians” and “wellbeing” Title and abstract review via Covidence Full text imported into NVivo Coding structure and Thematic Analysis Remaining articles divided between two reviewers

Results

Wellbeing

Family and community Culture, spirituality, and identity Country Basic Needs Work, roles, and responsibilities Autonomy, empowerment, recognition Education Physical health Mental health

Results

• Commonly noted as most

important domain

• Provides social capital and

connection

• Strength of Indigenous identity

emerges through culture and spirituality

• Practicing culture strongly

associated with positive wellbeing

Family & community

Culture, spirituality & identity

Ongoing impacts of colonisation and government policies disrupts connection and undermines wellbeing

Results

• Holistic, multi-dimensional

concept including more than land

• Sense of belonging to the land
• Restorative and builds resilience
• Profoundly important against a

backdrop of colonisation, marginalisation and trauma

• Agency and choice in decisions

from individual to national level, including self determination Country

Autonomy, empowerment, recognition

Ongoing impacts of colonisation and government policies disrupts connection/control and undermines wellbeing

Results

• SEWB
• Circularity of term as domain of

wellbeing

• Poor health related to poor

wellbeing

• Caused by disempowerment due to

continued dispossession and cultural dislocation

• Often paired as “health and

wellbeing”

Mental health

Physical health

Collectivist and holistic understandings of mental and physical health

Results

• Food security
• Money to meet basic

living need

• Good quality housing
• Equitable access to

services

• Benefits of working for

Aboriginal community- controlled groups and

• rganisations
• Wellbeing benefits from

work involving culture

• Cultural, community and

familial roles such as Elders

Basic needs

Work, roles and responsibilities Education

• Tension between

formal schooling and maintaining cultural education and knowledge

Conclusions

• Identified a wide range of wellbeing domains

potentially important to Indigenous Australians

• Domains range far beyond those typically measuring in

QOL and HRQOL instruments

• Identifying these domains takes steps toward

constructing a culturally-appropriate wellbeing and PROM instruments

Study team

Investigators

• Professor Kirsten Howard (University of Sydney)
• Professor Gail Garvey (Menzies School of Health

Research)

• Professor Julie Ratcliffe (University of South Australia)
• Associate Professor Allison Tong (University of Sydney)
• Professor Joan Cunningham (Menzies School of Health

Research)

• Professor Alan Cass (Menzies School of Health Research)
• Dr Lisa Whop (Menzies School of Health Research)

Project Managers: Dr Kate Anderson and Dr Tamara Butler Project Staff: Mr Brian Arley, Ms Alana Gall, Mr David Copley NHMRC Project Grant 1125434. Duration of funding: 2017 - 2021