Djäkamirr: Exploring principles used in piloting the training of First Nations doulas in a remote multilingual Northern Australian community setting.

Problem And Background: There is growing evidence in First Nations doula care as a strategy to address perinatal inequities and improve maternal care experiences. However, there is no evidence around the approach and principals required to successfully deliver First Nations doula (childbirth) training.

Question/aim: To explore and describe the approach and principles used in piloting the training of First Nations doulas in remote, multilingual Northern Australian community settings.

A call for action that cannot go to voicemail: Research activism to urgently improve Indigenous perinatal health and wellbeing.

In this call to action, a coalition of Indigenous and non-Indigenous researchers from Australia, Aotearoa New Zealand, United States and Canada argue for the urgent need for adequately funded Indigenous-led solutions to perinatal health inequities for Indigenous families in well-resourced settler-colonial countries. Authors describe examples of successful community-driven programs making a difference and call on all peoples to support and resource Indigenous-led perinatal health services by providing practical actions for individuals and different groups.

Facilitating Sustainable Disaster Risk Reduction in Indigenous Communities: Reviving Indigenous Worldviews, Knowledge, and Practices through Two-Way Partnering.

The Sendai Framework of Action 2015-2030 calls for holistic Indigenous disaster risk reduction (DRR) research. Responding to this call, we synergized a holistic philosophical framework (comprising ecological systems theory, symbolic interactionism, and intersectionality) and social constructionist grounded theory and ethnography within a critical Indigenous research paradigm as a methodology for exploring how diverse individual and contextual factors influence DRR in a remote Indigenous community called Galiwinku, in the Northern Territory of Australia. Working together, Indigenous and non-Indigenous researchers collected stories in local languages using conversations and yarning circles with 20 community members, as well as participant observations.

"We are sacred": An intercultural and multilingual approach to understanding reproductive health literacy for Yolŋu girls and women in remote Northern Australia.

Issue Addressed: Indigenous women continue to experience reproductive health inequities. While enhancing health literacy is suggested as an approach for reducing disparities and increasing equity, there is a paucity of literature exploring Indigenous women's conceptualisation of reproductive health literacy. This paper demonstrates one approach to developing a reproductive health literacy framework for Yolŋu (Indigenous) women in a remote Northern Australian setting.

Caring for Mum On Country: Exploring the transferability of the Birthing On Country RISE framework in a remote multilingual Northern Australian context.

Background & Problem: Birthing On Country (BOC) is an international movement for returning childbirth to First Nations peoples and their communities. The RISE Framework was developed to guide evidence-based BOC implementation but has not yet been tested in a remote Australian community setting.

Aim: To test the transferability and acceptability of the RISE Framework in a remote multilingual setting in a Yolŋu (First Nations) community in Northern Australia.

Finding a pathway and making it strong: Learning from Yolŋu about meaningful health education in a remote Indigenous Australian context.

Issue Addressed: Access to meaningful health information is limited in remote regions of Australia where Indigenous languages and culture are strong but the prevalence of chronic conditions is extremely high. This qualitative study aimed to support and understand the evolution of an educational approach to improve communication about chronic conditions for Yolŋu (Aboriginal people of Northeast Arnhem Land).

Methods: Within a culturally responsive research design, data were gathered through participant observation and semi-structured interviews with educators and community members.

Chronic condition risk factor change over time in a remote Indigenous community.

Introduction: This study sought to determine change in chronic condition risk factors in a remote Indigenous community following a 3-year period of community-led health promotion initiatives.

Methods: Data were compared between two cross-sectional surveys of Indigenous Australian community residents before and after health promotion activities, and longitudinal analysis of participants present at both surveys using multilevel mixed-effects regression.

Results: At baseline, 294 (53% women; mean age 35 years) participated and 218 attended the second survey (56% women, mean age 40 years), and 87 attended both.

Recurrence patterns identify aggressive form of human papillomavirus-dependent vulvar cancer.

Background: Vulvar cancer is rare and, as a result, is understudied. Treatment is predominantly surgery, irrespective of the type of vulvar cancer, and is associated with physical, emotional and sexual complications. A cluster of human papillomavirus (HPV)-dependent vulvar cancer patients was identified in Arnhem Land Northern Territory (NT), Australia, in which young Indigenous women were diagnosed at 70 times the national incidence rate.

Building Yolŋu Skills, Knowledge, and Priorities into Early Childhood Assessment and Support: Protocol for a Qualitative Study.

Background: Yolngu or Yolŋu are a group of indigenous Australian people inhabiting north-eastern Arnhem Land in the Northern Territory of Australia. Recent government policy addressing disparities in outcomes between Indigenous and other children in Australia has resulted in the rapid introduction of early childhood interventions in remote Aboriginal communities. This is despite minimal research into their appropriateness or effectiveness for these contexts.

Challenges to Providing Fetal Anomaly Testing in a Cross-Cultural Environment: Experiences of Practitioners Caring for Aboriginal Women.

Background: Across Australia there are substantial disparities in uptake of antenatal testing for fetal anomalies, with very low uptake observed among Aboriginal women. The reasons behind these disparities are unclear, although poorer access to testing has been reported in some communities. We interviewed health care practitioners to explore the perceived barriers to providing fetal anomaly screening to Aboriginal women.

Food, food choice and nutrition promotion in a remote Australian Aboriginal community.

Contemporary diets of Aboriginal people living in remote Australia are characterised by processed foods high in fat and sugar. Within the 'new' food system, evidence suggests many Aboriginal people understand food in their own terms but lack access to consumer information about store-purchased foods, and parents feel inadequate as role models. In a remote Australian Aboriginal community, purposive sampling identified adults who participated in semistructured interviews guided by food-based themes relating to the contemporary food system, parental guidance of children's food choice and channels through which people learn.

Runs of homozygosity and a cluster of vulvar cancer in young Australian Aboriginal women.

Objective: A cluster of vulvar cancer exists in young Aboriginal women living in remote communities in Arnhem Land, Australia. A genetic case-control study was undertaken involving 30 cases of invasive vulvar cancer and its precursor lesion, high-grade vulvar intraepithelial neoplasia (VIN), and 61 controls, matched for age and community of residence. It was hypothesized that this small, isolated population may exhibit increased autozygosity, implicating recessive effects as a possible mechanism for increased susceptibility to vulvar cancer.

Factors influencing food choice in an Australian Aboriginal community.

We explored with Aboriginal adults living in a remote Australian community the social context of food choice and factors perceived to shape food choice. An ethnographic approach of prolonged community engagement over 3 years was augmented by interviews. Our findings revealed that knowledge, health, and resources supporting food choice were considered "out of balance," and this imbalance was seen to manifest in a Western-imposed diet lacking variety and overrelying on familiar staples.

'Give us the full story': overcoming the challenges to achieving informed choice about fetal anomaly screening in Australian Aboriginal communities.

This cross-cultural qualitative study examined the ethical, language and cultural complexities around offering fetal anomaly screening in Australian Aboriginal communities. There were five study sites across the Northern Territory (NT), including urban and remote Aboriginal communities. In-depth interviews were conducted between October 2009 and August 2010, and included 35 interviews with 59 health providers and 33 interviews with 62 Aboriginal women.

"Hiding the story": indigenous consumer concerns about communication related to chronic disease in one remote region of Australia.

This paper reports on a collaborative qualitative study which explored education and communication practice related to chronic disease from the perspectives of Aboriginal people in a remote region of the Northern Territory, Australia, where the prevalence of chronic disease is extremely high. Most Yolngu (Aboriginal people of Northeast Arnhem Land) do not speak English as their first language and few health staff share the language and cultural background of their clients. Semi-structured interviews were conducted with Yolngu community members and health staff in their preferred language in small groups or individually, in an approach that was flexible and responsive to the concerns and priorities of Yolngu researchers and participants.

Integrating an ecological approach into an Aboriginal community-based chronic disease prevention program: a longitudinal process evaluation.

Background: Public health promotes an ecological approach to chronic disease prevention, however, little research has been conducted to assess the integration of an ecological approach in community-based prevention programs. This study sought to contribute to the evidence base by assessing the extent to which an ecological approach was integrated into an Aboriginal community-based cardiovascular disease (CVD) and type 2 diabetes prevention program, across three-intervention years.

Methods: Activity implementation forms were completed by interview with implementers and participant observation across three intervention years.

Leanness and type 2 diabetes in a population of indigenous Australians.

Objective: To determine the prevalence of type 2 diabetes and its risk factors in a population of indigenous Australians.

Research Design And Methods: A cross-sectional study of 332 indigenous community residents aged 15 years and over with fasting blood samples and anthropometric measurements.

Results: Almost half of the study population (47.