Perspectives of Aboriginal People Affected by Cancer on the Need for an Aboriginal Navigator in Cancer Treatment and Support: A Qualitative Study.

Aboriginal and Torres Strait Islander Australians suffer higher rates of cancer and poorer outcomes than the wider population. These disparities are exacerbated by rurality and remoteness due to reduced access and limited engagement with health services. This study explored the cancer journeys of Aboriginal patients and carers, and their views on the establishment of an Aboriginal Patient Navigator role within the Western Australian healthcare system to support cancer patients and their families.

Improving Access to Cancer Treatment Services in Australia's Northern Territory-History and Progress.

Cancer is the leading cause of death in the Northern Territory (NT), Australia's most sparsely populated jurisdiction with the highest proportion of Aboriginal people. Providing cancer care to the NT's diverse population has significant challenges, particularly related to large distances, limited resources and cultural differences. This paper describes the developments to improve cancer treatment services, screening and end-of-life care in the NT over the past two decades, with a particular focus on what this means for the NT's Indigenous peoples.

Respect, Relationships, and "Just Spending Time with Them": Critical Elements for Engaging Aboriginal Students in Primary School Education.

While disparities in educational outcomes for Aboriginal children have narrowed in early childhood education and for Year 12 completions, these positive trends are not replicated in the intervening years where attendance, reading, writing, and numeracy targets have been missed. Erratic attendance in the primary years has the greatest impact on achievement; literacy and numeracy scores decline as absences increase. Family functioning and health, caregiver expectations, past encounters with the education system and socio-economic disadvantage are all implicated in poorer rates of attendance.

Longitudinal Follow Up of Early Career Midwives: Insights Related to Racism Show the Need for Increased Commitment to Cultural Safety in Aboriginal Maternity Care.

Racism in health care undermines equitable service delivery, contributes to poorer health outcomes and has a detrimental effect on the Aboriginal workforce. In maternity care settings, Aboriginal women's perceptions of discrimination are widespread, with the importance of cultural practices surrounding childbirth often not recognised. Efforts to build midwives' cultural capabilities and address health disparities have seen Aboriginal content included in training programs but little is known about its application to clinical practice.

Cultural respect in midwifery service provision for Aboriginal women: longitudinal follow-up reveals the enduring legacy of targeted program initiatives.

Background: Culturally competent maternity care provision to Aboriginal and Torres Strait Islander women was identified as a priority area by Australia's National Maternity Services Plan in 2011. While midwifery programs responded by including core Indigenous content and community placements in curricula, little is known about whether knowledge learned, and insights gained in response to these initiatives have endured and been applied in clinical practice. This follow-up study explores the impact of a compulsory Indigenous unit and a remote clinical placement on two cohorts of non-Indigenous midwives who were participants in an earlier 2012-14 study.

Learning from follow-up of student placements in a remote community: a small qualitative study highlights personal and workforce benefits and opportunities.

Background: The maldistribution of the Australian health workforce contributes to restricted accessibility and poorer health outcomes for rural and remote populations, especially Aboriginal and Torres Strait Islander Australians. Student exposure to rural and remote settings is a long-term strategy that aims to reduce workforce shortages by encouraging rural career uptake, with well-supervised, positive placement experiences associated with rural practice intentions. Furthermore, placements can build students' cultural capabilities and foster interest in working with disadvantaged and underserved Aboriginal communities.

Applying a Midwifery Lens to Indigenous Health Care Delivery: The Contribution of Campus Learning and Rural Placements to Effecting Systemic Change.

Study Background: Increasing cultural safety in health settings is essential to address stark health disparities between Indigenous and non-Indigenous Australians. Respect for cultural knowledge, better communication, and recognition of racism as a determinant of health are required for improved service delivery. How this knowledge is acquired in health professional training and translated to clinical settings is poorly understood.

Up close and real: living and learning in a remote community builds students' cultural capabilities and understanding of health disparities.

Background: Rural and remote communities in Australia fare worse than their urban counterparts across major health indicators, with geographic isolation, restricted accessibility to health services, socioeconomic disadvantage, lifestyle and behavioural factors all implicated in poorer health outcomes. Health disparities, which are especially stark in Australian Aboriginal and Torres Strait Islander populations, underscore the urgent need to build a culturally responsive and respectful rural health workforce. Allied health student placements in settings with high Aboriginal populations provide opportunities for the development of cultural capabilities and observation of the causes and impact of health disparities.

Promoting women's health in remote Aboriginal settings: Midwifery students' insights for practice.

Objective: To describe midwifery students' insights on promoting health to Aboriginal women in remote Australia following a supervised clinical placement.

Design: Semistructured, in-depth interviews were conducted with all midwifery students who undertook the placement between 2010 and 2013.

Setting: Aboriginal communities on the Ngaanyatjarra Lands, Western Australia.

Exploring undergraduate midwifery students' readiness to deliver culturally secure care for pregnant and birthing Aboriginal women.

Background: Culturally secure health care settings enhance accessibility by Aboriginal Australians and improve their satisfaction with service delivery. A culturally secure health service recognises and responds to the legitimate cultural rights of the recipients of care. Focus is upon the health care system as well as the practice and behaviours of the individuals within it.

"Listening to the silence quietly": investigating the value of cultural immersion and remote experiential learning in preparing midwifery students for clinical practice.

Background: Cultural immersion programs are increasingly offered to medical and health science students in an effort to provide experiential learning opportunities that focus on 'the self' as well as 'the other'. Immersion programs encourage self-reflection on attitudes towards cultural differences, provide opportunities to build relationships and work with community members, and allow students to apply knowledge and skills learned in training programs in a supervised practice setting. The aim of this paper is to describe midwifery students' reflections on a remote Aboriginal clinical placement that has been offered at a Western Australian university since 2010.

Confronting uncomfortable truths: receptivity and resistance to Aboriginal content in midwifery education.

Objectives: The emotional responses of students undertaking a new, compulsory unit on Indigenous cultures and health were investigated as part of a broader study looking at culturally secure practice in midwifery education and service provision for Aboriginal women.

Methods: Classroom observations were conducted on a first year midwifery cohort from July to October 2012 and students completed 'before and after' questionnaires.

Results: A spectrum of emotional responses was identified and found to be consistent with studies of medical student exposure to Aboriginal content.

Refining the concept of cultural competence: building on decades of progress.

Cultural competence strategies aim to make health services more accessible for patients from diverse cultural backgrounds. Recently, such strategies have focused on specific groups, and particularly Indigenous Australians, where services have failed to address large disparities in health outcomes. Limitations of cultural competence largely fall into three categories: lack of clarity around how the concept of culture is used in medicine, inadequate recognition of the "culture of medicine" and the scarcity of outcomes-based research that provides evidence of efficacy of cultural competence strategies.