Annual Progress Reports
Winanga-li: Indigenous worldview's incorporated into m-health approaches for Indigenous women and children (1178993)
- Associate Professor Kym Rae (Chief Investigator A)
- University of Queensland
- Budget: $1,127,874.50
- Funding period: 2020 to 2024
Project Synopsis
Socio-economic disadvantage, geographical isolation in many areas of Australia, environmental conditions for growing and storing food, and social factors greatly influence the current diet, nutritional status and food security experienced by the Aboriginal and Torres Strait Islander (respectfully Indigenous) people. Nutrition is a key environmental influence in the early developmental stages of pregnancy, and optimal nutrition throughout the lifespan is protective of a broad range of adverse health outcomes. A nourishing diet is important for maternal health during pregnancy and for optimal fetal growth and development. To date, there is very limited existing literature that reports the dietary needs of Indigenous women during pregnancy. There is a clear gap in the literature that needs to be addressed as poor nutrition during pregnancy is recognised as a significant modifiable determinant in the development of chronic disease in offspring in later life. This proposal seeks to build the body of evidence surrounding nutritional support needs of Indigenous women during pregnancy and post-partum period for Indigenous women. Embedded within this proposal plan is a model of rigorous capacity building that will build research skills for Indigenous staff. This proposal will incorporate Indigenous worldviews of nutrition in the perinatal periods and will undertake a participatory action research plan to consult, and co-design a mobile health tool to support women during this time. This app will have a focus on provision of nutritional education and provide culturally appropriate educational resources for women that can then be stored on their personal device for future use. This tool will also enable health professionals to use this to support antenatal nutrition education. This proposal will significantly impact on nutritional policies to best support Indigenous women.
Progress report April 2023
Phase 1 data collection has been completed in South East QLD at Galangoor Duwalami, and Carbal Aboriginal Health services and Pius X Moree (NSW). Preliminary analysis of these focus groups has been undertaken and detailed analysis begun. Data collection for Phase 1 is planned for 2023 for WA sites.
The Indigenous Steering Committee for this project has been formed and are meeting regularly.
The CI team meet regularly and have held a training/planning workshop in co-design methods to plan upcoming Phase 2 workshops.
It is anticipated that Phase 2 workshops will begin in South East QLD when analysis of Phase 1 is complete and all mock-ups and preparation undertaken.
Significant time has been spent growing relationships with each of the Aboriginal community-controlled services that this project is partnered with. Its Indigenous Steering Committee has been formed and are meeting regularly. Data analysis is underway from the data collected at 3 sites from Queensland with data collection to be undertaken in NSW and WA in coming weeks. Phase 2 workshops are proposed to begin by mid-2023.
Publications and other Resources
Gilbert, S., Irvine, R., D’Or, M., Rae, K., & Murphy, N. (2023). Working with Indigenous Australian communities designing a nutritional mHealth tool during the Covid-19 pandemic. AlterNative: An International Journal of Indigenous Peoples, 19(3), 574-583. https://doi.org/10.1177/11771801231189346
Gilbert S, Irvine R, D'or M, Adam MTP, Collins CE, Marriott R, Rollo M, Walker R, Rae K (2023). Indigenous Women and Their Nutrition During Pregnancy (the Mums and Bubs Deadly Diets Project): Protocol for a Co-designed mHealth Resource Development Study. JMIR Res Protoc; 12:e45983. https://doi.org/10.2196/45983
An early start to nutritional health: Improving breastfeeding of Western Australian Aboriginal babies (1179689)
- Professor Daniel McAullay (Chief Investigator A)
- Edith Cowan University
- Budget: $1,345,275.00
- Funding period: 2020 to 2024
Project Synopsis
The proportion of Aboriginal and non-Aboriginal babies exclusively breastfed on discharge is 86.8% and 90.4% respectively. These proportions drop dramatically in the following six months to 11% and 27.2%, with the disparity steadily increasing. Studies conducted in the Perth metropolitan area over a decade ago showed that Aboriginal babies born in urban areas had the lowest rates of exclusive breastfeeding in the state. The WHO has recognised the importance of exclusively breastfeeding a baby for a minimum of six months to ensure a healthy start to life. Breastfeeding has been shown to be a protective factor against asthma and allergy development, ear disease, infections, respiratory illness and gastrointestinal issues. This study aims to improve exclusive breastfeeding rates of Aboriginal and Torres Strait Islander infants in the Perth Metropolitan area. We aim to achieve this through an Interrupted Time Series (ITS) analysis study design whereby outcomes are observed over several time points before and after the implementation of an intervention. The intervention, a Continuous Quality Improvement (CQI) program, designed with staff and community input will be tested at the largest birthing hospital in Western Australia and will involve nine community Aboriginal Health Team sites across the metropolitan area. CQI is an important tool for health services to achieve strong governance, assurance and service improvement.
The study will allow us to determine the breastfeeding rates of Aboriginal babies, identify the barriers and enablers to initiating and maintaining breastfeeding and determine whether a CQI program can achieve improvements in breastfeeding rates.
Progress report April 2023
We have conducted 69 surveys with Health Service Providers (HSP) and face-to-face interviews with two HSP. Four in depth interviews with mothers have been completed. The Community Health intervention sites have been chosen and agreed upon. The intervention training package has been developed and is ready for implementation. Intervention training of site staff will commence in July 2023. The intervention will commence in September 2023 and be completed by December 2023. Discussions with the data linkage branch to receive required administrative data are ongoing.
Giving Aboriginal and Torres Strait Islander children the best start in life: improving healthy food affordability and food security in remote Australia (1179848)
- Dr Megan Ferguson (Chief Investigator A)
- The University of Queensland
- Budget: $2,102,692.00
- Funding period: 2020 to 2024
Project Synopsis
Food insecurity affects diet quality and contributes to malnutrition, diet-related disease and inter-generational poverty. Nationally, 31% of Aboriginal and Torres Strait Islander people living in remote communities are food insecure, though this is likely to be higher at up to 62%. This is in the context of high food costs and growing poverty.
This study, designed with Apunipima Cape York Health Council staff and leading academics, aims to determine effective mechanisms to improve food security in remote Australia. It will target pregnant/breastfeeding women and carers of children under 5 years who reside in four communities, in two regions. Phase One of the study will employ a before-and-after study design to test how a price discount, will improve the affordability of a healthy diet. The primary outcome will determine how diet quality changes across participants from intervention and control communities. Secondary outcomes include food security and anaemia.
Phase Two will focus on translation to policy using photo voice (participants will take images relating to their experiences of food insecurity). The participant determined themes generated from this technique will inform the development of policy messages which will be tested with the general public to maximise traction of our advocacy efforts to policy-makers. The study will directly lead to a community framework to propose solutions to alleviate food insecurity, inform policy approaches, and give children the best start in life by addressing the inter-generational impacts of food insecurity.
Progress report April 2023
The Remote Food Security project is a collaboration between remote Aboriginal and Torres Strait Islander Community Advisory Groups, Aboriginal Community Controlled Health Organisations and academics. We have tested the impact of a healthy food discount card on diet quality and healthy food affordability for women and children in remote communities. We have conducted a photovoice study with parents/carers of young children, facilitated community prioritisation processes and developed a community-led framework with community leaders. We are working with community leaders to maximise opportunities for this evidence to be translated into current policy opportunities.
Evaluation of a community-led nutrition and lifestyle program for weight loss and metabolic health: a randomised controlled trial (1179067)
- Professor Beverley-Ann Biggs (Chief Investigator A)
- University of Melbourne
- Budget: $1,508,143.99
- Funding period: 2020 to 2023
Project Synopsis
Aboriginal Australians suffer from a disproportionate burden of chronic diseases compared to other Australians. Current prevention strategies to improve health and nutrition in Indigenous communities often fail to recognise the pivotal role that kinship, culture, family, and community play in understanding behavioural risk factors for metabolic syndrome (poor diet, lack of exercise, smoking) and associated chronic diseases. Working with Yolngu Elders in NE Arnhem Land and local organisations, we will conduct a novel experiential learning program that embeds concepts about healthy nutrition and lifestyle in the Yolngu’s complex interactions between culture and connection to land, family, and community. We plan to assess the effectiveness of this four-month program on weight loss and other health indicators and to understand Yolngu perspectives on the benefits and challenges of the program and its interface with Yolngu life and ways of knowing and experiencing the body and health. The project will provide local employment and skills development, and results will inform planning for more effective, sustainable strategies to foster improved nutrition and health in remote Aboriginal communities, with the longer-term potential of reducing chronic disease morbidity and mortality.
Progress report April 2023
To date we have enrolled 69 residents of Elcho Island and completed baseline measurements of cardiometabolic health. We have recorded that the trial health assessments in some participants have led to earlier detection and management of health issues as well as raised awareness and knowledge about metabolic health, nutrition and exercise in the community. Blood biomarker data was shared with Miwatj health for patient care, 43 participants received their baseline blood results and 46 participants received their endline blood results. The study has a follow up rate of 85% with 56 of the 66 participants completing assessments for the primary outcome. Currently the study is in the data checking and statistical analysis phase for the evaluation of the program.