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"Those of us who have worked on the frontline of Aboriginal health for any length of time know that beneath the surface reality of Aboriginal people's poor health outcomes sits a deeper truth. It is about the importance of social and emotional wellbeing, and how this flows from a sense of control over one's own life. Where this is lacking, as it is in so many Aboriginal families and communities, there is instead indifference and despair and a descent into poor lifestyle choices and self-destructive behaviours. Our medical professionals do a great job of prescribing medicines and devising treatment programs but, to fix the root causes of ill-health, we need something more. As Aboriginal people we need to have a sense of agency in our lives, that we are not stray leaves blowing about in the wind. In a word, we need empowerment". Dr. Pat Anderson, Chairperson, the Lowitja Institute, Australia's National Institute for Aboriginal and Torres Strait Islander Health Research.

Life expectancy for Indigenous Australians is approximately 20 years less than that of other Australians, & endemic family violence is a causal factor. This article discusses evaluation data gathered from an Indigenous empowerment program aimed at increasing personal empowerment in order to improve individual & social well being. Our analysis of the data demonstrates the success of the program in building personal strength, increasing ability to assist others, & increasing motivation to challenge structural factors impacting on health equality. We consider the operational implications of a human rights framework & argue that empowerment programs & human rights discourse, focusing on exploration of self & an analysis of colonization, discrimination, & human rights, could empower individuals & communities with an innovative approach to challenging health inequality. Adapted from the source document.

Life expectancy for Indigenous Australians is approximately 20 years less than that of other Australians, and endemic family violence is a causal factor. This article discusses evaluation data gathered from an Indigenous empowerment program aimed at increasing personal empowerment in order to improve individual and social wellbeing. Our analysis of the data demonstrates the success of the program in building personal strength, increasing ability to assist others, and increasing motivation to challenge structural factors impacting on health equality. We consider the operational implications of a human rights framework and argue that empowerment programs and human rights discourse, focusing on exploration of self and an analysis of colonization, discrimination, and human rights, could empower individuals and communities with an innovative approach to challenging health inequality. (Original abstract

Abstract Background Smoking rates in Australian Aboriginal and Torres Strait Islander peoples remain high, with limited impact of government measures for many subgroups. The aim of this cross-sectional study was to investigate differences in organisational practice for developing anti-tobacco messages for these target populations. Methods Telephone interviews were conducted with 47 organisation representatives using a structured questionnaire based on health communication and health promotion frameworks. Responses were coded into phases of message development, message types (educational, threat, positive or advocacy), target groups, message recommendations, and evaluations undertaken. Cultural sensitivity for message development was divided into surface structure (use of images, language, demographics) and deep structure (use of socio-cultural values). A categorical principal component analysis explored the key dimensions of the findings and their component relationships. Results Among organisations interviewed, a community-orientated, bottom-up approach for developing anti-tobacco messages was reported by 47% (n = 24); 55% based message development on a theoretical framework; 87% used a positive benefit appeal; 38% used threat messages. More Aboriginal Medical Services (AMSs) targeted youth (p < 0.005) and advised smokers to quit (p < 0.05) than other types of organisations. AMSs were significantly more likely to report using deep structure in tailoring messages compared with non-government (p < 0.05) and government organisations (p < 0.05). Organisations that were oriented to the general population were more likely to evaluate their programs (p < 0.05). A two-dimensional non-linear principal component analysis extracted components interpreted as "cultural understanding" (bottom-up, community-based approaches, deep structures) and "rigour" (theoretical frameworks, and planned/completed evaluations), and accounted for 53% of the variability in the data. Conclusion Message features, associated with successful campaigns in other populations, are starting to be used for Aboriginal and Torres Strait Islander peoples. A model is proposed to facilitate the development of targeted anti-tobacco messages for Aboriginal and Torres Strait Islander peoples. Organisations could consider incorporating both components of cultural understanding-rigour to enable the growth of evidence-based practice.

Background Smoking rates in Australian Aboriginal and Torres Strait Islander peoples remain high, with limited impact of government measures for many subgroups. The aim of this cross-sectional study was to investigate differences in organisational practice for developing anti-tobacco messages for these target populations. Methods Telephone interviews were conducted with 47 organisation representatives using a structured questionnaire based on health communication and health promotion frameworks. Responses were coded into phases of message development, message types (educational, threat, positive or advocacy), target groups, message recommendations, and evaluations undertaken. Cultural sensitivity for message development was divided into surface structure (use of images, language, demographics) and deep structure (use of socio-cultural values). A categorical principal component analysis explored the key dimensions of the findings and their component relationships. Results Among organisations interviewed, a community-orientated, bottom-up approach for developing anti-tobacco messages was reported by 47% (n = 24); 55% based message development on a theoretical framework; 87% used a positive benefit appeal; 38% used threat messages. More Aboriginal Medical Services (AMSs) targeted youth (p < 0.005) and advised smokers to quit (p < 0.05) than other types of organisations. AMSs were significantly more likely to report using deep structure in tailoring messages compared with non-government (p < 0.05) and government organisations (p < 0.05). Organisations that were oriented to the general population were more likely to evaluate their programs (p < 0.05). A two-dimensional non-linear principal component analysis extracted components interpreted as "cultural understanding" (bottom-up, community-based approaches, deep structures) and "rigour" (theoretical frameworks, and planned/completed evaluations), and accounted for 53% of the variability in the data. Conclusion Message features, associated with ...

Introduction: This paper describes the development of a 'Research for Impact' Tool against a background of concerns about the over-researching of Aboriginal and Torres Strait Islander people's issues without demonstrable benefits. Material and Methods: A combination of literature reviews, workshops with researchers and reflections by project team members and partners using participatory snowball techniques. Results: Assessing research impact is difficult, akin to so-called 'wicked problem', but not impossible. Heuristic and collaborative approach to research that takes in the expectations of research users, those being researched and the funders of research offers a pragmatic solution to evaluating research impact. The proposed 'Research for Impact' Tool is based on the understanding that the value of research is to create evidence and/or products to support smarter decisions so as to improve the human condition. Research is of limited value unless the evidence produced is used to inform smarter decisions. A practical way of approaching research impact is therefore to start with the decisions confronting decision makers whether they are government policymakers, professional practitioners or households and the extent to which the research supports smarter decisions and the knock-on consequences of such smart decisions. Embedded at each step in the impact planning, monitoring and evaluation process is the need for Indigenous leadership and participation, capacity enhancement and collaborative partnerships and participatory learning by doing approaches across partners. Discussion: The tool is designed in the context of Indigenous research but the basic idea that the way to assess research impact is to start upfront by defining the users' of research and their information needs, the decisions confronting them and the extent to which research informs smarter decisions is equally applicable to research in other settings, both applied and theoretical. Beyond research, the tool can be adapted more broadly to ...

IntroductionYoung people who have contact with the youth justice system are distinguished by a high prevalence of complex, co-occurring health problems, including known risk factors for preventable mortality. However, almost nothing is known about health outcomes for these young people after separation from the youth justice system.
Objectives and ApproachWe aimed to examine the incidence, timing, causes and risk factors for death in justice-involved young people. We linked youth justice records in Queensland, Australia 1993-2016 (N=48,963) with adult correctional records and the National Death Index. We split the cohort into three subgroups: those who had ever been in detention (n=7,643), those supervised in the community but never detained (n=12,953), and those charged with an offence but never convicted (n=28,367). We calculated all-cause and cause-specific crude mortality rates (CMRs), and indirectly standardised mortality ratios (SMRs). We used Cox regression to identify static and time-varying risk factors for death.
ResultsDuring a median of 13.6 years of follow-up there were 1,452 deaths (3.0%). The all-cause CMR was 2.2 (95%CI 2.1-2.3) per 1000 person-years, and the all-cause SMR was 3.1 (95%CI 3.0-3.3). The leading external causes of death were suicide (32% of all deaths), transport accidents (16%), accidental drug-related causes (13%), and violence (3%). In adjusted analyses, independent risk factors for all-cause mortality included being male (HR=1.4, 95%CI 1.2-1.6) and older (>=15 vs. vs. charge only; HR=1.6, 95%CI 1.2-2.0) and subsequent incarceration as an adult (HR=1.8, 95%CI 1.4-2.4).
Conclusion/ImplicationsYoung people who have contact with the youth justice system are at markedly increased risk of preventable death, after separation from that system. Efforts to improve long-term health outcomes for justice-involved youth have the potential to reduce preventable deaths in these highly vulnerable young people.

Introduction: This paper examines the process of developing a Research for Impact Tool in the contexts of general fiscal constraint, increased competition for funding, perennial concerns about the over-researching of Aboriginal and Torres Strait Islander issues without demonstrable benefits as well as conceptual and methodological difficulties of evaluating research impact. The aim is to highlight the challenges and opportunities involved in evaluating research impact to serve as resource for potential users of the research for impact tool and others interested in assessing the impact of research. Material and Methods: A combination of literature reviews, workshops with researchers and reflections by project team members and partners using participatory snowball techniques. Results: Assessing research impact is perceived to be difficult, akin to so-called 'wicked problem', but not impossible. Heuristic and collaborative approach to research that takes in the expectations of research users, those being researched and the funders of research offers a pragmatic solution to evaluating research impact. The logic of the proposed Research for Impact Tool (Figure 2) is based on the understanding that the value of research is to create evidence and/or products to support smarter decisions so as to improve the human condition. Research is therefore of limited value unless the evidence created is used to make smarter decisions for the betterment of society. A practical way of approaching research impact is therefore to start with the decisions confronting decision makers whether they are government policymakers, industry, professional practitioners or households and the extent to which the research supports them to make smarter policy and practice decisions and the knock-on consequences of doing so. Embedded at each step in the impact planning and tracking process is the need for appropriate mix of expertise, capacity enhancement and collaborative participatory learning by doing approaches. Discussion: The tool was developed in the context of Aboriginal and Torres Strait Islander research but the basic idea that the way to assess research impact is to start upfront with the information needs of decisions makers is equally applicable to research in other settings, both applied (horizontal) and basic (vertical) research. The tool will be further tested and evaluated with researchers over the next two years (2016/17). The wider challenge is to engage with major Australian research funding agencies to ensure consistent alignment and approaches across research users, communities and funders in evaluating impact.