A program to respond to otitis media in remote Australian Aboriginal communities: a qualitative investigation of parent perspectives.

BACKGROUND: Indigenous infants and children in Australia, especially in remote communities, experience early and chronic otitis media (OM) which is difficult to treat and has lifelong impacts in health and education. The LiTTLe Program (Learning to Talk, Talking to Learn) aimed to increase infants' access to spoken language input, teach parents to manage health and hearing problems, and support children's school readiness. This paper aimed to explore caregivers' views about this inclusive, parent-implemented early childhood program for 0-3 years in an Aboriginal community health context. METHODS: Data from in-depth, semi-structured interviews with 9 caregivers of 12 children who had participated in the program from one remote Aboriginal community in the Northern Territory are presented. Data were analysed thematically. Caregivers provided overall views on the program. In addition, three key areas of focus in the program are also presented here: speech and language, hearing health, and school readiness. RESULTS: Caregivers were positive about the interactive speech and language strategies in the program, except for some strategies which some parents found alien or difficult: such as talking slowly, following along with the child's topic, using parallel talk, or baby talk. Children's hearing was considered by caregivers to be important for understanding people, enjoying music, and detecting environmental sounds including signs of danger. Caregivers provided perspectives on the utility of sign language and its benefits for communicating with infants and young children with hearing loss, and the difficulty of getting young community children to wear a conventional hearing aid. Caregivers were strongly of the opinion that the program had helped prepare children for school through familiarising their child with early literacy activities and resources, as well as school routines. But caregivers differed as to whether they thought the program should have been located at the school itself. CONCLUSIONS: The caregivers generally reported positive views about the LiTTLe Program, and also drew attention to areas for improvement. The perspectives gathered may serve to guide other cross-sector collaborations across health and education to respond to OM among children at risk for OM-related disability in speech and language development.

What's worrying young Australians and where do they go for advice and support? Policy and practice implications for their well-being.

AIM: The Mission Australia annual National Survey of Young Australians aims to generate insights into what young people think on a range of issues, including what they value, what issues are of concern to them, and where they go for advice and support. METHODS: A two-page opt-in questionnaire was distributed to a very broad range of organisations across Australia, and was available in both an online and paper-based format. Responses to the survey were anonymous. Respondents were asked to rank items from the lists provided, and results are reported on the basis of items ranked one, two or three by respondents. Responses were disaggregated by age, gender, cultural background and living arrangements. RESULTS: Close to 48,000 young people participated in the 2009 survey, and the data confirms the importance of relationships to young people, as well as the diversity of concerns they may have, including drugs, suicide, mental health and body image. While concerns tended to vary with age and to some extent gender, what is valued by young people tends to be consistent across age and genders, namely family and friends. CONCLUSIONS: Implications for policy making and service delivery are drawn with a focus on the issues of relationships, drugs and mental health. In particular, the need for early intervention, evidence-based drug education programs, and initiatives that support those closest to young people, to assist them when they have concerns, are highlighted.