Partnerships in Aboriginal and Torres Strait Islander health research

Abstract

This thesis comprises a collection of applied epidemiological studies including an evaluation and epidemiological study, an outbreak investigation, and a data analysis. All studies are focused on Aboriginal and Torres Strait Islander One Health (which recognises that the health of people is related to the health of animals and their interaction with the environment), sexual health, and child health. All studies highlight the importance of partnerships and community involvement.

The first study is an evaluation of a community driven animal health and management program in the remote Aboriginal community of Wadeye in the Northern Territory. Wadeye has approximately 2300 residents and 650 dogs and cats. However, there is very limited access to veterinary care and animal medicines. To address community concerns regarding animal health, an animal health and management program was co-developed and implemented by Animal Management in Rural and Remote Indigenous Communities (AMRRIC) and the Thamarrurr Development Corporation (TDC) Rangers, with support from the West Daly Regional Council. This study is a quantitative epidemiological study that evaluated the impact of this animal health and management program in Wadeye. This included analysing animal and human health outcomes before and after program implementation to assess the impact of the animal program on the health of animals and people within the community. This study involved engagement and partnerships with AMRRIC and TDC, as well as the community of Wadeye.

The second study is an outbreak investigation analysing Human Immunodeficiency Virus (HIV) notifications among the Aboriginal and Torres Strait Islander population in Far North Queensland to determine if an outbreak has occurred. The Tropical Public Health Unit - Cairns observed an increase in HIV notifications since 2014 affecting the Aboriginal and Torres Strait Islander population. HIV has been notifiable in Queensland since 1984. This study is a quantitative descriptive analysis, using the Queensland Notifiable Conditions database, to analyse data on HIV notifications from 1 January 1984 - 30 June 2019, to quantify the history of HIV notifications and assess whether an outbreak has occurred. This study involved engagement and partnerships with local health organisations, Queensland Health, and the South Australia Health and Medical Research Institute (SAHMRI).

The third study is a data analysis focusing on chronic disease risk in Aboriginal children involved in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). SEARCH is a cohort study of Aboriginal children and adolescents and is conducted with four Aboriginal Community Controlled Health Services (ACCHS) in New South Wales. Chronic disease affects Aboriginal and Torres Strait Islander adults at higher rates than non-Indigenous Australian adults. However, it is not clear if this risk emerges during childhood and/or adolescence. This study is a cross-sectional analysis that quantifies the distribution of chronic disease markers in the cohort overall, and in relation to age group, gender, and Body Mass Index (BMI). This study involved engagement and partnerships with two ACCHS including the Tharawal Aboriginal Medical Service (based in Western Sydney), and the Riverina Medical and Dental Aboriginal Corporation (based in Wagga Wagga), and also the SEARCH project team based at the Sax Institute.

The teaching requirements of the MAE are also detailed in this thesis including a lessons from the field session about the use of logic models in evaluations and a teaching session about One Health in field epidemiology.