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1.
Rural Remote Health ; 22(4): 7657, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2081330

ABSTRACT

INTRODUCTION: The first outbreak of the omicron variant of COVID-19 in the Torres and Cape region of Far North Queensland in Australia was declared in late December 2021. A COVID-19 Care at Home program was created to support the health and non-health needs of people with COVID-19 and their families throughout the mandatory isolation periods and included centralising the coordination and delivery of COVID-19 therapeutics. The therapeutics available included one intravenous monoclonal antibody (sotrovimab) and two oral antiviral therapies: nirmatrelvir and ritonavir (Paxlovid®) and molnupiravir (Lagevrio®). This article describes the uptake and delivery of this therapeutics program. METHODS: COVID-19 cases were documented in a notification database, screened to determine eligibility for COVID-19 therapies and prioritised based on case age, vaccination status, immunosuppression status and existing comorbidities, in line with Queensland clinical guidelines. Eligible cases were individually contacted by phone to discuss treatment options, and administration of therapies were coordinated in partnership with local primary healthcare centres and hospitals. RESULTS: A total of 4744 cases were notified during the outbreak period, of which 217 (4.6%) were deemed eligible for treatment after medical review. Treatment was offered to 148/217 cases (68.2%), with 90/148 cases (60.8%) declining treatment and 53/148 cases (35.8%) receiving therapeutic treatment for COVID-19. Among these 53 cases, 29 received sotrovimab (54.7%), 20 received Paxlovid (37.7%) and four received Lagevrio (7.5%). First Nations people accounted for 48/53 cases (90.6%) who received treatment, and COVID-19 therapeutics were delivered to cases in 16 remote First Nations communities during the outbreak period. CONCLUSION: The COVID-19 Care at Home program demonstrated a novel, public health led approach to delivering time-critical medications to individuals across a large, remote and logistically complex region. The application of similar models to outbreaks and chronic conditions of public health importance offers potential to address many health access inequities experienced by remote Australian First Nations communities.


Subject(s)
COVID-19 , Health Services, Indigenous , Humans , Native Hawaiian or Other Pacific Islander , Queensland/epidemiology , Australia/epidemiology , COVID-19/epidemiology , Ritonavir , SARS-CoV-2 , Disease Outbreaks , Antibodies, Monoclonal , Antiviral Agents
2.
Int J Environ Res Public Health ; 19(18)2022 Sep 14.
Article in English | MEDLINE | ID: covidwho-2055218

ABSTRACT

Two years after the onset of the COVID-19 pandemic, many nations and communities continue to grapple with waves of infection and social fallout from pandemic fatigue and frustration. While we are still years away from realizing the full impacts of COVID-19, reflecting on our collective responses has offered some insights into the impact that various public health policies and decisions had on nations' abilities to weather the multifaceted impacts of the pandemic. Widely believed to have the potential to be devastated by COVID-19, many Indigenous communities in Canada were extremely successful in managing outbreaks. This paper outlines one such example, Wapekeka First Nation, and the community's formidable response to the pandemic with a specific focus on food mobilization efforts. Built on over a decade of community-based participatory action research and informed by six interviews with key pandemic leaders in the community, this paper, co-led by two community hunters and band council members, emphasizes the various decisions and initiatives that led to Wapekeka's successful pandemic response. Proactive leadership, along with strong traditional harvesting and processing efforts, helped to take care of the community while they remained strictly isolated from virus exposure.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Canada/epidemiology , Community-Based Participatory Research , Humans
3.
Int J Environ Res Public Health ; 19(16)2022 08 20.
Article in English | MEDLINE | ID: covidwho-2023675

ABSTRACT

The dietary transition from traditional to commercial foods and a decrease in physical activity (PA) have impacted the health of the First Nations people of Quebec (Canada), resulting in many suffering from multiple chronic diseases. This study had two objectives: (1) to examine eating and PA behaviors among First Nations peoples in urban areas and (2) to explore the associated health representations. To achieve these objectives, a mixed-methods approach, including a questionnaire (n = 32) and a semi-structured interview (n = 14), was used to explore the participants' lifestyle profiles and health experiences. The questionnaire focused on the eating and PA behaviors of First Nations people and their underlying motivations. At the same time, the interviews investigated their health views on diet and PA behaviors based on the conceptual framework of health and its determinants. According to the participants, health is the autonomy to live without pain by maintaining a balance between physical and psychological aspects, eating healthy and exercising. Family and work influence participants' PA and eating behaviors. Exploring First Nations people's beliefs and perceptions and the motivations underlying their health behaviors could help encourage the maintenance of a healthy lifestyle despite multiple chronic health conditions.


Subject(s)
Feeding Behavior , Health Behavior , Diet/psychology , Exercise , Humans , Motor Activity
4.
7th International Conference on Distance Education and Learning, ICDEL 2022 ; : 6-11, 2022.
Article in English | Scopus | ID: covidwho-2020429

ABSTRACT

The recent COVID pandemic has demonstrated that distance learning is no longer a function of broadcasting conventional classroom content to a decentralized audience. Rather than perpetuate disengaged dissemination of content commonplace in in-person teaching environments, educators have aspired to elicit engagement with diverse and rich content available on the internet. This is merely a harbinger of increased demand by students and educators alike for more robust and interactive content. To meet this ambition, an initiative to create a virtual simulation for architecture students to immerse themselves in a historic Canadian First Nations settlement from centuries in the past to better understand the parallels between indigenous approaches to architecture and contemporary praxis. Drawing upon video game infrastructure, the downloadable content fostered accurate and detailed depictions of various building systems as reconstructed as a collaboration between architecture, archaeology, and game design faculty. Rather than simply presented with authoritative facts, within this highly detailed open world, students were able to engage and explore content on their own in understanding the commonalities with contemporary design strategies that provided a greater experiential learning capacity. © 2022 ACM.

5.
Front Public Health ; 10: 904158, 2022.
Article in English | MEDLINE | ID: covidwho-1987601

ABSTRACT

Objective: The primary aim of the study was to translate and evaluate the impact of a Physical Activity (PA) program on the physical function of older Aboriginal Elders on Noongar Boodjar (Country). Methods: A longitudinal design framed within an Indigenous methodology. Two groups, one metropolitan and one regional, of Aboriginal Elders, aged ≥45 years, participated in the Ironbark PA program. This comprised weekly strength and balance exercises followed by yarning circles. Physical function (primary outcome) and functional ability, cardiovascular risk factors (weight, waist circumference), falls efficacy and health-related quality of life were measured at baseline 6, 12 and 24 months. Data were analyzed using generalized linear mixed effects modeling. Results: Fifty-two Elders initially enrolled and of those, n = 23 (44.2%) Elders participated regularly for 24 months. There was a 6-month gap in program delivery due to the COVID-19 pandemic. Participants made significant improvement in physical function at 12 months compared to baseline: [short physical performance battery (SPPB) at baseline, 8.85 points (95% CI 8.10, 9.61); 12 months 10.28 (95% CI 9.44, 11.13), p = 0.001: gait speed at baseline 0.81 ms-1 (95% CI 0.60, 0.93); 12 months 1.14 (95% CI 1.01, 1.27), p < 0.001]. Some sustained improvement compared to baseline was still evident at 24 months after the 6-month gap in attendance [SPPB 9.60 (8.59, 10.60) p = 0.14, gait speed 1.11 (0.95, 1.26) p < 0.001]. Cardiovascular risk factors showed a non-significant improvement at 12 and 24 months compared to baseline. All participants reported that they enjoyed the program, found it culturally appropriate and would recommend it to others. Conclusion: Older Aboriginal people showed sustained improvements in physical function after engaging in a culturally appropriate PA program. Culturally appropriate PA programs provide safety, security and choice for older Aboriginal people to engage in evidence-based PA.


Subject(s)
COVID-19 , Native Hawaiian or Other Pacific Islander , Aged , Exercise , Humans , Longitudinal Studies , Pandemics , Quality of Life
6.
44th AMOP Technical Seminar on Environmental Contamination and Response 2022 ; : 361-373, 2022.
Article in English | Scopus | ID: covidwho-1958255

ABSTRACT

A group of British Columbia North Pacific Coast First Nations (NPC Nations) have been actively developing Geographic Response Strategies (GRS) within their territories since 2018. A multi-year project plan included three years of field work (2019-2021), during which technical experts would support First Nations communities in transferring knowledge and practice. The implementation of lockdowns, travel restrictions, and public health advisories beginning in March 2020 substantially changed the planned approach and ultimately spurred novel approaches to remotely supporting field surveys and mentoring First Nations community members to lead oil spill response surveys. To enable the continuation of field work, a contracting team worked closely with the NPC Nations to create a strategic approach to collaborate through web-based conference platforms and cloud-based GIS. There were several imperatives to continue this work – First Nations communities view marine oil spill planning as a top priority based on past spills in their territories and risks from coastal shipping. The project funding was grant-based and time-bound, expiring at the end of FY2021-22. Despite the pandemic, the participating First Nations still had a successful field season with roughly 40 combined days in the field from April 2020 to November 2021, with approximately 221 sites surveys and close to 500 tactics developed. Through innovation, collaboration, and trial and error, 12 BC First Nations continued to develop GRS to help strengthen their marine response capacity while adhering to the strict COVID-19 guidelines set in place by their local communities, which were often more stringent than provincial and national policies to protect their elders and other vulnerable community members in remote areas with limited medical facilities. This paper discusses the specific modifications to the field surveying process driven by the pandemic and the technology tools used to communicate and capture data accurately. In addition, this paper examines how Geographic Information System (GIS) was incorporated into the GRS development, including GIS training for community members and the use of tablet-based applications to gather field data. It describes a successful approach to peer-to-peer knowledge transfer across First Nations communities, building a community of practice and mutual support. Finally, this paper reports lessons learned and suggests best practices to continue broadening the marine response and preparedness capacity within the BC First Nations. © 2022 44th AMOP Technical Seminar on Environmental Contamination and Response. All rights reserved.

7.
Int J Ment Health Syst ; 16(1): 22, 2022 Apr 29.
Article in English | MEDLINE | ID: covidwho-1951275

ABSTRACT

BACKGROUND: First Nations (FN) people of Canada experience health, social, and systemic inequities due to colonization. Consequently, COVID-19 has placed further mental health stress on people related to personal finances, employment security and worry over infection, resulting in exacerbated effects of unresolved past medical and physical traumas. This study aims to understand the experiences related to mental health in an Alberta FN community during the early stages of the pandemic. METHODS: In partnership with FN leadership, the study implemented an online cross-sectional survey. Adults from a large FN community in Alberta, Canada, were asked to complete a survey, including two mental health-related screening questionnaires: (1) Generalized Anxiety Disorder-2 item; and (2) Patient Health Questionnaire-2 item. In addition, respondents could provide responses to open-ended questions about their experiences. RESULTS: Among 106 respondents, 95 (89.6%) finished the survey; 18% of adults screened positive for depressive symptoms (score of 3 or greater) and reported difficulty following public health advice for using hand sanitizer, maintaining social distancing, or self-isolating. 21% of adults screened positive for symptoms of anxiety (score of 3 or greater) and reported difficulty maintaining social distance, self-isolating, obtaining food and clothing, or meeting other basic living requirements. CONCLUSIONS: FN communities may be disproportionately affected by COVID-19, and may experience exacerbated symptoms of anxiety, depression and overall poor mental health and well-being. Additional supports and services, including for mental health, should be considered for FN in the context of COVID-19 public health measures. HIGHLIGHTS: The COVID-19 pandemic has brought upon increased stress and accompanying symptoms of anxiety and depression for a First Nations community in Alberta. Studies, such as this one, that characterize the influence of the COVID-19 pandemic on mental health among First Nations people, are urgently needed because of increasing demands on healthcare systems due to the pandemic and potential delays in the care of patients living with pre-existing mental health conditions. There is an opportunity to capitalize on First Nations people's experiences of post-traumatic growth proactively supporting/maintaining their well-being and possibly the development of community-based mental health interventions and supports.

8.
Prehosp Disaster Med ; 37(4): 429-430, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1931264

ABSTRACT

Extreme heat and wildfires have health implications for everyone; however, minority and low-income populations are disproportionately negatively affected due to generations of social inequities and discriminatory practices. Indigenous people in Canada are at a higher risk of many chronic respiratory diseases, as well as other non-communicable diseases and hospitalization, compared to the general population. These wildfires occurring during the COVID-19 pandemic have demonstrated how disruptive compounding disasters can be, putting minority populations such as First Nations, Metis, and Inuit tribes at increased risk and decreased priority. Going forward, if the necessarily proactive mitigation and preparedness steps are not undertaken, the ability to attenuate health inequity in the indigenous community by building resiliency to wildfire disasters will be significantly hampered.


Subject(s)
Wildfires , Canada/epidemiology , Humans
9.
BMC Public Health ; 22(1): 1276, 2022 06 30.
Article in English | MEDLINE | ID: covidwho-1910303

ABSTRACT

INTRODUCTION: This study investigated differences between rural Australian First Nations and non-First Nations survey respondents' perceptions of COVID-19-related risks and analysed other variables that could predict an exacerbation of anxiety related to COVID-19 harms. METHODS: A cross-sectional online and paper survey of rural residents from the western regions of NSW, Australia, was conducted. Descriptive and multivariate statistical analyses were used to assess links between First Nations status and demographic measures including postcode, age, gender, education, rural or town/village location, proximity to medical services and living situation. The analysis included five items related to perceptions about COVID-19: perceived likelihood of contracting COVID-19 in the next 12 months, perceived harmfulness of the virus, how often people felt afraid, perception about respondents' ability to do something about the virus and perceived economic impacts of the pandemic. RESULTS: There were significant differences between First Nations (n=60) and non-First Nations (n= 639) respondents across all sociodemographic categories. The results reflect a significantly higher level of anxiety among the First Nations Australians in the sample: they felt afraid more often, felt it was highly likely they would catch the virus and if they did catch the virus perceived that it would be very harmful. Living with children under eighteen years of age and in small rural towns were key factors linked to feeling afraid of COVID-19 and First Nations status. CONCLUSION: Health risk communication in pandemic response should include an equitable focus on rural areas, recognising that First Nations Australians are a significant proportion of the rural population with different risk factors and concerns than those of non-First Nations Australians. This principle of First Nations-led design is critical to all health policy and planning. The Australian Government should include rural areas in planning pandemic responses, recognising that First Nations populations are a significant proportion of the rural population creating syndemic conditions.


Subject(s)
COVID-19 , Health Communication , Australia/epidemiology , COVID-19/epidemiology , Child , Cross-Sectional Studies , Humans , Rural Population , Surveys and Questionnaires
10.
Public Health ; 207: 119-126, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1867698

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has highlighted the importance of access to telehealth as an alternative model of service during social restrictions and for urban and remote communities alike. This study aimed to elucidate whether First Nations and culturally and linguistically diverse (CALD) patients also benefited from the resource before or during the pandemic. STUDY DESIGN: This study was a scoping review. METHODS: A scoping review of MEDLINE, CINAHL and PsycINFO databases from 2000 to 2021 was performed. Paired authors independently screened titles, abstracts and full texts. A narrative synthesis was undertaken after data extraction using a standard template by a team including First Nations and CALD researchers. RESULTS: Seventeen studies (N = 4,960 participants) mostly qualitative, covering First Nations and CALD patient recipients of telehealth in the United States, Canada, Australia, and the Pacific Islands, met the inclusion criteria. Telehealth was perceived feasible, satisfactory, and acceptable for the delivery of health screening, education, and care in mental health, diabetes, cancer, and other chronic conditions for remote and linguistically isolated populations. The advantages of convenience, lower cost, and less travel promoted uptake and adherence to the service, but evidence was lacking on the wider availability of technology and engagement of target communities in informing priorities to address inequalities. CONCLUSIONS: Further studies with larger samples and higher level evidence methods involving First Nations and CALD people as co-designers will assist in filling the gap of safety and cultural competency.


Subject(s)
COVID-19 , Telemedicine , Cultural Diversity , Feasibility Studies , Humans , Pandemics , Personal Satisfaction
11.
Can Commun Dis Rep ; 48(4): 119-123, 2022 Apr 06.
Article in English | MEDLINE | ID: covidwho-1818784

ABSTRACT

The National Collaborating Centre for Indigenous Health (NCCIH) is unique among the National Collaborating Centres as the only centre focused on the health of a population. In this fifth article of the Canada Communicable Disease Report's series on the National Collaborating Centres and their contribution to Canada's public health response to the coronavirus disease 2019 (COVID-19) pandemic, we describe the work of the NCCIH. We begin with a brief overview of the NCCIH's mandate and priority areas, describing how it works, who it serves and how it has remained flexible and responsive to evolving Indigenous public health needs. Key knowledge translation and exchange activities undertaken by the NCCIH to address COVID-19 misinformation and to support the timely use of Indigenous-informed evidence and knowledge in public health decision-making during the pandemic are also discussed, with a focus on acting on lessons learned moving forward.

12.
Journal of Rural and Community Development ; 16(4):28-53, 2021.
Article in English | GIM | ID: covidwho-1716735

ABSTRACT

The relationship of COVID-19 rates to community infrastructure is explored through a literature review, mapping, and an ecological-level statistical analysis in this paper. The analysis was undertaken with data from Manitoba, Canada, for 23 of 63 First Nations and 67 non-First Nations communities. COVID-19 community-level per capita rates were estimated by dividing total cases, including active cases,-obtained from the COVID-19 Manitoba Open Data portal of the Public Health Information Monitoring System, PHIMS-for the community areas of Regional Health districts by the community 2021 Manitoba population report numbers. The geographical areas for COVID-19 data were identical to the census subdivision levels available from Statistics Canada, used for housing and other infrastructure data. COVID-19 per capita rates in Manitoba communities have a positive significant strong relationship with community rates for (a) overcrowded housing (r = 0.532, p < 0.05), (b) unsuitability of housing (r = 0.623, p < 0.05), (c) houses needing major repairs (r = 0.561, p < 0.05), (d) no access roads (t = 2.281, p <0.05), and (e) lack of hospitals (t= 2.024, p<0.047). The highest rates for COVID-19 and the worst infrastructure are located in First Nations, particularly in special access communities. This preliminary research signals a need to improve infrastructure in First Nations reserves to realize health equity. Further research on built environment conditions in all Manitoba communities with age- and sex-adjusted analysis of COVID-19 data is needed to comprehend the role of infrastructure more fully.

13.
Health Res Policy Syst ; 20(1): 12, 2022 Jan 21.
Article in English | MEDLINE | ID: covidwho-1700769

ABSTRACT

BACKGROUND: Recognition of the role of structural, cultural, political and social determinants of health is increasing. A key principle of each of these is self-determination, and according to the United Nations (2007), this is a right of Indigenous Peoples. For First Nations Australians, opportunities to exercise this right appear to be limited. This paper explores First Nations Australian communities' responses to reducing alcohol-related harms and improving the health and well-being of their communities, with a focus on understanding perceptions and experiences of their self-determination. It is noted that while including First Nations Australians in policies is not in and of itself self-determination, recognition of this right in the processes of developing health and alcohol policies is a critical element. This study aims to identify expert opinion on what is needed for First Nations Australians' self-determination in the development of health- and alcohol-related policy. METHODS: This study used the Delphi technique to translate an expert panel's opinions into group consensus. Perspectives were sought from First Nations Australians (n = 9) and non-Indigenous Peoples (n = 11) with experience in developing, evaluating and/or advocating for alcohol interventions led by First Nations Australians. Using a web-based survey, this study employed three survey rounds to identify and then gain consensus regarding the elements required for First Nations Australians' self-determination in policy development. RESULTS: Twenty panellists (n = 9 First Nations Australian) participated in at least one of the three surveys. Following the qualitative round 1 survey, six main themes, 60 subthemes and six examples of policy were identified for ranking in round 2. In round 2, consensus was reached with 67% of elements (n = 40/60). Elements that did not reach consensus were repeated in round 3, with additional elements (n = 5). Overall, consensus was reached on two thirds of elements (66%, n = 43/65). CONCLUSIONS: Self-determination is complex, with different meaning in each context. Despite some evidence of self-determination, systemic change in many areas is needed, including in government. This study has identified a starting point, with the identification of elements and structural changes necessary to facilitate First Nations Australian community-led policy development approaches, which are vital to ensuring self-determination.


Subject(s)
Public Policy , Australia , Delphi Technique , Humans , Personal Autonomy
14.
Can J Public Health ; 113(1): 67-80, 2022 02.
Article in English | MEDLINE | ID: covidwho-1608031

ABSTRACT

OBJECTIVES: The First Nations people experience significant challenges that may influence the ability to follow COVID-19 public health directives on-reserve. This study aimed to describe experiences, perceptions and circumstances of an Alberta First Nations community, related to COVID-19 public health advice. We hypothesized that many challenges ensued when following and implementing advice from public health experts. METHODS: With First Nations leadership and staff, an online cross-sectional survey was deployed between April 24 and June 25, 2020. It assessed the appropriateness of public health advice to curb COVID-19 within this large First Nations community. Both quantitative and qualitative data were captured and described. RESULTS: A total of 106 adults living on-reserve responded; over 80% were female. Difficulty accessing food was significant by employment status (p = 0.0004). Those people with lower income found accessing food (p = 0.0190) and getting essential medical care (p = 0.0060), clothing (p = 0.0280) and transportation (p = 0.0027) more difficult. Some respondents described lost income associated with COVID-19 experiences, as well as difficulties accessing essential supplies. Respondents found "proper handwashing" most easy (98%) and "keeping a distance of 2 m from others" most difficult (23%). Many respondents found following public health advice within their personal domain easy and put "family safety" first but experienced some difficulties when navigating social aspects and obligations, particularly when unable to control the actions of others. People stated wanting clear information, but were sometimes critical of the COVID-19 response. CONCLUSION: First Nations people face many additional challenges within the COVID-19 response, driven in part by ongoing issues related to significant societal, economic, and systemic factors.


RéSUMé: OBJECTIFS: Les Premiers Peuples connaissent d'importantes difficultés qui peuvent nuire à la capacité de suivre les directives de santé publique sur la COVID-19 dans les réserves. Notre étude visait à décrire les expériences, les perceptions et la situation d'une Première Nation de l'Alberta en lien avec les consignes de santé publique sur la COVID-19. Nous avons postulé que de nombreuses difficultés s'ensuivent lorsque les conseils des spécialistes de la santé publique sont suivis et appliqués. MéTHODE: Avec les dirigeants et le personnel de la Première Nation, nous avons mené un sondage transversal en ligne entre le 24 avril et le 25 juin 2020. Le sondage évaluait la pertinence des consignes de santé publique pour contenir la COVID-19 dans cette grande communauté. Des données quantitatives et qualitatives ont été saisies et décrites. RéSULTATS: En tout, 106 adultes vivant dans la réserve ont répondu; plus de 80 % étaient des femmes. Les difficultés d'accès aux aliments selon la situation d'emploi étaient significatives (p = 0,0004). Les personnes à faible revenu trouvaient plus difficile d'accéder aux aliments (p = 0,0190) et d'obtenir des soins médicaux essentiels (p = 0,0060), de se procurer des vêtements (p = 0,0280) et de trouver de moyens de transport (p = 0,0027). Certains répondants ont fait état de pertes de revenus associées à leurs expériences de la COVID-19, et de difficultés d'accès aux fournitures essentielles. Les répondants ont trouvé que « bien se laver les mains ¼ était la consigne la plus facile à respecter (98 %), et que « rester à 2 mètres les uns des autres ¼ était la plus difficile (23 %). De nombreux répondants ont trouvé facile de respecter les consignes de santé publique dans leur domaine personnel et d'accorder la priorité à « la santé familiale ¼, mais ont éprouvé des difficultés à négocier les obligations et aspects sociaux, particulièrement lorsqu'ils ne pouvaient pas contrôler les actions des autres. Les gens ont dit vouloir des informations claires, mais ont parfois critiqué la riposte à la COVID-19. CONCLUSION: Les Premiers Peuples font face à de nombreuses difficultés supplémentaires dans le cadre de la riposte à la COVID-19; ces difficultés résultent en partie de problèmes persistants liés à d'importants facteurs sociétaux, économiques et systémiques.


Subject(s)
COVID-19 , Adult , Alberta , Cross-Sectional Studies , Female , Humans , Public Health , SARS-CoV-2
15.
Nutrients ; 13(11)2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1542681

ABSTRACT

Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components.


Subject(s)
Cardiovascular Diseases/prevention & control , Diet, Healthy/methods , Health Promotion/methods , Australia , Cardiovascular Diseases/ethnology , Diet, Healthy/ethnology , Health Services, Indigenous , Heart Disease Risk Factors , Humans , Outcome Assessment, Health Care , Program Evaluation
16.
Intern Med J ; 51(11): 1806-1809, 2021 11.
Article in English | MEDLINE | ID: covidwho-1462814

ABSTRACT

The NSW Government has proposed a blanket lifting of COVID-19 restrictions when the proportion of fully vaccinated people rate reaches 70% of the adult population. If implemented, this would have devastating effects on Aboriginal populations. At the present time, vaccination rates in Aboriginal communities remain low. Once restrictions are lifted, unvaccinated people will be at high risk of infection. The risks of serious illness and death among Aboriginal people from a variety of medical conditions are significantly greater than for the wider population. This is also the case with COVID-19 in First Nations populations around the world. The vulnerability of Aboriginal people is an enduring consequence of colonialism and is exacerbated by the fact that many live in overcrowded and poorly maintained houses in communities with under-resourced health services. A current workforce crisis and the demographic structure of the population have further hindered the effectiveness of vaccination programmes. Aboriginal organisations have called on state and federal governments to delay any substantial easing of restrictions until full vaccination rates among Aboriginal and Torres Strait Islander populations aged 16 years and older reach 90-95%. They have also called for additional support in the form of supply of vaccines, enhancement of workforce capacity and appropriate incentives to address hesitancy. Australia remains burdened by the legacy of centuries of harm and damage to its First Nations people. Urgent steps must be taken to avoid a renewed assault on Aboriginal and Torres Strait Islander health.


Subject(s)
COVID-19 , Health Services, Indigenous , Adult , Australia , Humans , SARS-CoV-2 , Vaccination
17.
Asia Pac J Public Health ; 33(5): 595-597, 2021 07.
Article in English | MEDLINE | ID: covidwho-1191217

ABSTRACT

The COVID-19 (coronavirus disease 2019) pandemic has the potential to worsen existing health inequalities faced by Aboriginal and Torres Strait Islander peoples in Australia. We aimed to assess the impact of the pandemic on First Nations people health assessments using an interrupted time series model utilizing data extracted from the Australian Medicare Benefits Schedule database. Additive triple exponential smoothing was used to model health assessments undertaken between January 2017 and December 2019. The model was used to predict health assessments between January 2020 and June 2020 with 95% confidence (P < .05). There was no significant difference between observed and predicted First Nations people health assessments in January, February, and June 2020. However, we found a statistically significant decrease in health assessments in March (16.5%), April (23.1%), and May (17.2%) 2020. The proportion of total health assessments delivered via telehealth was 0.5%, 23.6%, 17.6%, and 10.0% for March, April, May, and June 2020, respectively. The decrease in total First Nations people health assessments compounds the risk of poorer health outcomes in this population already vulnerable due to a high burden of chronic disease and considerable social, economic, and health inequalities. Strategies to improve the delivery of telehealth for First Nations people must be considered.


Subject(s)
COVID-19 , Aged , Australia/epidemiology , Humans , National Health Programs , SARS-CoV-2
18.
Can J Public Health ; 111(6): 971-974, 2020 12.
Article in English | MEDLINE | ID: covidwho-1083707

ABSTRACT

Due to overcrowding and subsequent unavoidable close contact, poor ventilation, and decreased hygiene standards and healthcare services as compared with in the community setting, the prison environment is highly conducive to the transmission of infections, including COVID-19. Physical distancing measures may be difficult to implement without introducing interventions that may violate human rights. Given that Indigenous women represent over 41% of federally incarcerated women, this is a cause for concern. Indigenous women are also more likely to have higher rates of numerous chronic conditions, including respiratory illnesses, substantially increasing vulnerability to COVID-19 complications. This can be exacerbated in prisons as access to healthcare may be limited. Outbreaks within the prison setting can not only overwhelm an already over-stretched healthcare system but also spread to the community and disproportionately impact marginalized communities and populations. In this commentary, we explore the public health and human rights implications of COVID-19 in prisons while calling particular attention to the unique needs and circumstances of incarcerated Indigenous women based on international best practice-based guidance to preventive and responsive measures to COVID-19.


RéSUMé: En raison du surpeuplement et des contacts étroits, de la mauvaise ventilation et des normes d'hygiène et des services de santé réduits qui en découlent inévitablement, le milieu carcéral est hautement propice à la transmission des infections, y compris la COVID-19, comparativement au milieu ouvert. Les mesures de distanciation physique peuvent être difficiles à y appliquer sans introduire des interventions potentiellement contraires aux droits de la personne. Comme les femmes autochtones représentent plus de 41 % de la population carcérale fédérale féminine, il faut s'en inquiéter. Les femmes autochtones sont aussi plus susceptibles de présenter de plus hauts niveaux de nombreux états chroniques, dont les maladies respiratoires, qui accroissent considérablement la vulnérabilité aux complications de la COVID-19. Cette situation est exacerbée en prison, où l'accès aux soins de santé peut être limité. Les éclosions en milieu carcéral peuvent non seulement submerger un système de soins de santé déjà trop sollicité, mais se propager au milieu ouvert et affecter démesurément les communautés et les populations marginalisées. Dans notre commentaire, nous explorons les conséquences, sur le plan de la santé publique et des droits de la personne, de la présence de la COVID-19 dans les établissements pénitentiaires et nous attirons une attention particulière sur les besoins spécifiques et la situation des femmes autochtones incarcérées, en nous fondant sur des directives de prévention et d'intervention face à la COVID-19 fondées sur les pratiques exemplaires internationales.


Subject(s)
COVID-19/epidemiology , Human Rights , Indigenous Peoples , Prisons , Public Health , Women , Canada/epidemiology , Female , Health Status Disparities , Healthcare Disparities , Humans , Pandemics , Prisoners
19.
Int J Environ Res Public Health ; 17(22)2020 11 11.
Article in English | MEDLINE | ID: covidwho-927688

ABSTRACT

The study is on racism against First Nation peoples in the Canadian healthcare system. The study design incorporates principles of grounded theory, participant and Indigenous (decolonizing) research. Four questions are addressed: (1) What is the root cause of racism against First Nation peoples in the healthcare system? (2) What factors perpetuate racisms existence? (3) What are the impacts of racism on First Nation health? (4) What needs to be done to eradicate racism and to create an equitable healthcare system that sufficiently represents the needs, interests and values of First Nation peoples?


Subject(s)
Delivery of Health Care , Indigenous Canadians , Racism , Canada , Delivery of Health Care/standards , Delivery of Health Care/statistics & numerical data , Humans , Indigenous Canadians/statistics & numerical data , Racism/prevention & control , Racism/statistics & numerical data
20.
Can J Aging ; 40(3): 512-517, 2021 09.
Article in English | MEDLINE | ID: covidwho-765949

ABSTRACT

Following Canadian estimates of frailty, academic researchers and the Chiefs of Ontario came together to create the first Ontario-wide profile of aging in First Nations people in Ontario. Using self-reported data from First Nations adults who participated in the Ontario First Nations Regional Health Survey Phase 2, we found that First Nations people in Ontario experience higher rates of frailty than the general Canadian population and early onset frailty appears to affect First Nations communities. This is important to consider as communities plan for health care needs of an aging population and is particularly relevant in the face of Covid-19, as we know severity is exacerbated by underlying health conditions.


Subject(s)
Aging , Frailty , Indigenous Canadians , Adult , Aged , Female , Health Surveys , Humans , Male , Middle Aged , Ontario , Self Report
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