Factors that sustain indigenous youth mentoring programs: a qualitative systematic review.

BACKGROUND: Indigenous youth worldwide continue to experience disproportional rates of poorer mental health and well-being compared to non-Indigenous youth. Mentoring has been known to establish favorable outcomes in many areas of health but is still in its early phases of research within Indigenous contexts. This paper explores the barriers and facilitators of Indigenous youth mentoring programs to improve mental health outcomes and provides evidence for governments' response to the United Nations Declaration on the Rights of Indigenous Peoples. METHODS: A systematic search for published studies was conducted on PubMed, Embase, Scopus, CINAHL, and grey literature through Trove, OpenGrey, Indigenous HealthInfoNet, and Informit Indigenous Collection. All papers included in the search were peer-reviewed and published from 2007 to 2021. The Joanna Briggs Institute approaches to critical appraisal, data extraction, data synthesis, and confidence of findings were used. RESULTS: A total of eight papers describing six mentoring programs were included in this review; six papers were from Canada, and two originated from Australia. Studies included mentor perspectives (n = 4) (incorporating views of parents, carers, Aboriginal assistant teachers, Indigenous program facilitators, young adult health leaders, and community Elders), mentee perspectives (n = 1), and both mentor and mentee perspectives (n = 3). Programs were conducted nationally (n = 3) or within specific local Indigenous communities (n = 3) with varying mentor styles and program focus. Five synthesized findings were identified from the data extraction process, each consisting of four categories. These synthesized findings were: establishing cultural relevancy, facilitating environments, building relationships, facilitating community engagement, and leadership responsibilities, which were discussed in the context of extant mentoring theoretical frameworks. CONCLUSION: Mentoring is an appropriate strategy for improving general well-being. However, more research is needed to explore program sustainability and maintaining outcomes in the long term.

Personalised music for residents with dementia in an Australian rural aged-care setting.

OBJECTIVE: Personalised music reportedly has a positive effect on behaviour and mood in people living with dementia. This intervention has not been conducted in low-resourced or rural aged-care settings. We evaluated the effect of a non-therapist-led personalised music listening intervention on residents with dementia and workplace culture in a rural aged-care facility in South Australia. DESIGN: Qualitative pilot study. SETTING: Rural aged-care home in South Australia. PARTICIPANTS: Ten residents with dementia and 15 aged-care staff participated in this study. INTERVENTIONS: Ten residents participated in an 8-week music program. Four focus groups were conducted with aged-care staff post-intervention. A thematic analysis was used to identify emerging themes. MAIN OUTCOME MEASURE: Personalised music positively influenced resident's behaviour and well-being, social interaction and the workplace environment and culture, and served as a useful tool for personalised care. RESULTS: Three themes emerged: quality of life, personalised care and better aged-care environment. Personalised music positively influenced resident's behaviour and well-being, social interaction and the workplace environment and culture, and served as a useful tool for personalised care. CONCLUSION: Personalised music program is an effective, low-cost intervention to improve quality of life and personalised care of residents living with dementia, staff well-being, and a workplace and culture in low-resourced or rural aged-care settings.

Factors that sustain Indigenous youth mentoring programs: a qualitative systematic review protocol.

OBJECTIVE: This qualitative systematic review aims to identify the barriers and enablers to delivering and sustaining Indigenous youth mentoring programs for improving mental health and reducing suicide rates. INTRODUCTION: The United Nations has called for global action to address Indigenous youth suicide and suicidal behavior. Indigenous youth mentoring programs aimed at improving mental health and reducing suicide rates have been conducted at smaller scales at other sites. Mentoring is culturally appropriate as it empowers communities and aligns with the principles of community, teaching and learning, kinship, and holistic health. There is a gap in the understanding of what the barriers and enablers of mentoring are in addressing Indigenous youth mental health and, ultimately, Indigenous youth suicide. INCLUSION CRITERIA: This review will consider studies that include mentoring programs specifically targeted at Indigenous youth mental health and well-being that are based within a community or organization setting. METHODS: Databases to be searched include CINAHL, PubMed, PsycINFO, Scopus, and Embase, as well as grey literature within Trove, OpenGrey, Indigenous HealthInfoNet, and Informit Indigenous Collection. The search will be limited to articles written in English and published from 2007 to the present. Titles and abstracts will be screened by two independent reviewers; full-text studies will be retrieved and assessed against the inclusion criteria. Results will be recorded in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram. Where possible, qualitative research findings will be pooled. Where textual pooling is not possible, the findings will be presented in narrative form.

The contribution of group work to the goals of comprehensive primary health care.

ISSUE ADDRESSED: Group work, such as peer support and health promotion is an important strategy available to comprehensive primary health care. However, group work and how it contributes to the goals of comprehensive primary health care has been under-researched and under-theorised. METHODS: In this 5-year study, we partnered with seven Australian primary health care services, and drew on service reports, two rounds of staff interviews (2009-2010 and 2013, N = 68 and 55), 10 community assessment workshops (N = 65), a client survey (N = 315) and case tracking of clients with diabetes (N = 184, plus interviews with 35 clients, and five practitioners) and clients with depression (N = 95, plus interviews with 21 clients, and 11 practitioners). We conducted a rapid literature review of existing research on group work, and developed a model showing a group work reinforcing cycle. We examined the nature of the groups run, and the benefits staff and clients perceived. RESULTS: Benefits were grouped into four main themes: (a) social support, including for clients of the Aboriginal services, opportunities to celebrate their cultural identity, (b) improving skills and knowledge, (c) increasing access to services and (d) empowerment and solidarity. CONCLUSIONS: The perceived collective and individual benefits aligned with a comprehensive primary health care vision. However, the individualism stressed by neoliberal-driven health policy threatened the provision of group work and its potential collectivist benefits. SO WHAT: There are multiple benefits of group work in primary health care that cannot be achieved through individual work, highlighting the importance of policy and organisational support for group work.

The feasibility and potential use of case-tracked client journeys in primary healthcare: a pilot study.

OBJECTIVES: To determine the feasibility of case-tracking methods in documenting client journeys at primary healthcare (PHC) services in order to investigate the comprehensiveness of service responses and the experiences of clients. DESIGN: Prospective pilot study. Quantitative and qualitative case management data were collected from staff via questionnaire or interview. SETTING: Five Australian multidisciplinary PHC services were involved including four South Australian state-managed and one Northern Territory Aboriginal community-controlled PHC service. PARTICIPANTS: Clients using services for depression (95) or diabetes (185) at the PHC services were case tracked over a 12-month period to allow construction of client journeys for these two conditions. Clients being tracked were invited to participate in two semi-structured interviews (21) and complete a health log. RESULTS: Though a number of challenges were encountered, the case-tracking methods were useful in documenting the complex nature of client journeys for those with depression or diabetes accessing PHC services and the need to respond to the social determinants of health. A flexible research design was crucial to respond to the needs of staff and changing organisational environments. CONCLUSIONS: The client journeys provided important information about the services' responses to depression and diabetes, and about aspects unique to comprehensive PHC such as advocacy and work that takes into account the social determinants of health.

Understanding the decision to commence a dose administration aid.

BACKGROUND: The use of dose administration aids (DAAs), such as compartmentalised boxes (eg dosette) or medicine packs (eg Webster-pak), is common, particularly among patients with chronic disease. The aim of this study was to investigate factors influencing patients' decisions to commence using a DAA with a view to summarising implications for practice for general practitioners (GPs). METHODS: Semi-structured interviews were undertaken with participants living in a regional town in South Australia. Analysis of transcripts was facilitated using a qualitative analysis grid. RESULTS: Eight participants were interviewed. Four main themes included complexity of managing medications, DAAs as a cultural artefact, taking the lead in decision making, and weight of influence of health professionals. DISCUSSION: This study highlights the role of individual autonomy, close relatives and pharmacy staff in decisions to commence using a DAA. Tablets included in DAAs can take priority over inhaled and injected medications. GPs have an important role in ensuring that commencing a DAA helps empower patients to improve their healthcare management and does not inhibit communication between patient, doctor and pharmacist.

Medicare Local-Local Health Network partnerships in South Australia: lessons for Primary Health Networks.

OBJECTIVES: To examine the partnerships in population health planning between Medicare Locals (MLs) and Local Health Networks (LHNs) in South Australia, and the factors that facilitated or constrained collaborations, to offer lessons for LHNs and Primary Health Networks. DESIGN, PARTICIPANTS AND SETTING: We conducted a qualitative study using individual interviews with key informants (executive or program leader staff) from the five South Australian MLs and the five South Australian LHNs. A total of 34 interviews were conducted between March and July 2014. RESULTS: Significant work was undertaken by MLs in the process of population health planning and needs assessment. Participants from both MLs and LHNs described examples of collaborative work, including data sharing and synthesis, program implementation and community consultation. The focus of LHNs on acute and intermediate care, the lack of system-level strategies to support collaboration, and constant policy and structural changes leading to uncertainty in the primary health care landscape were perceived as key barriers to collaboration. CONCLUSIONS: The experience of MLs and their achievements in building relationships and trust with stakeholders in their regions, including LHNs, provide valuable lessons for the new Primary Health Networks in Australia.