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Closing the gaps in and through Indigenous health research: guidelines, processes and practices.

Abstract: Research in Aboriginal contexts remains a vexed issue given the ongoing inequities and injustices in Indigenous health. It is widely accepted that good research providing a sound evidence base is critical to closing the gap in Aboriginal health and wellbeing outcomes. However, key contemporary research issues still remain regarding how that research is prioritised, carried out, disseminated and translated so that Aboriginal people are the main beneficiaries of the research in every sense. It is widely acknowledged that, historically, research on Indigenous groups by non-Indigenous researchers has benefited the careers and reputations of researchers, often with little benefit and considerably more harm for Indigenous peoples in Australia and internationally. This paper argues that genuine collaborative and equal partnerships in Indigenous health research are critical to enable Aboriginal and Torres Islander people to determine the solutions to close the gap on many contemporary health issues. It suggests that greater recognition of research methodologies, such as community participatory action research, is necessary to ensure that Aboriginal people have control of, or significant input into, determining the Indigenous health research agenda at all levels. This can occur at a national level, such as through the National Health and Medical Research Council (NHMRC) Road Map on Indigenous research priorities (RAWG 2002), and at a local level through the development of structural mechanisms and processes, including research ethics committees' research protocols to hold researchers accountable to the NHMRC ethical guidelines and values which recognise Indigenous culture in all aspects of research.

Introduction

Drawing on the current relevant national--and to a lesser extent, international--literature, this paper first examines some of the paradoxes regarding the implementation gap between governance, structures, funding and accountability practices and existing National Health and Medical Research Council (NHMRC) Indigenous research and ethics guidelines; second, it describes two case studies as exemplars of good research processes and practices that attempt to address these concerns; and, finally, it suggests that there is a critical need to incorporate cultural competence at a system, organisational and individual level to ensure that all researchers are more culturally responsive and sensitive in developing, implementing and disseminating research in partnership with Aboriginal and Torres Strait Islander people.

The research history within Aboriginal and Torres Strait Islander contexts

In Australia the history and practice of health research with Indigenous peoples is bound up with colonisation and exploitation (Henry et al. 2004; Humphery 2002; Nakata 2007; Rigney 1997). The first national conference to discuss Aboriginal health research ethics highlighted concerns about matters of ownership and control of the research agenda in Aboriginal and Torres Strait Islander contexts. Held in Alice Springs in 1986, the conference (entitled 'Research Priorities to Improve Aboriginal Health') was hosted by the Special Purposes Committee of the NHMRC and the Menzies School of Health Research. At the meeting, many researchers had their practices challenged by Aboriginal and Torres Strait Islander people for the first time. Conference delegates introduced a broad agenda to institutionally re-position the funding, conduct and control of Aboriginal and Torres Strait Islander health research away from traditional research establishments and funding bodies (Humphrey 2002).

Subsequently, a working party of Aboriginal people was formed to work in partnership with the NHMRC to draft the Interim Guidelines on Ethical Matters in Aboriginal and Torres Strait Islander Health Research (NHMRC 1991), which were issued in 1991. While the interim guidelines had a high degree of community ownership and were endorsed by the National Aboriginal and Islander Health Organisation, issues related to Indigenous control of Indigenous research funding and outcomes remained contentious, and the guidelines were not formally ratified by the NHMRC before being revised and re-issued in 2003. Nevertheless, the guidelines served to transform research practice with Aboriginal and Torres Strait Islander people and communities (Humphery 2002).

The NHMRC Guidelines for Ethical Indigenous Research

One of the most recent sets of guidelines, the NHMRC (2003) Values and Ethics: Guidelines for ethical conduct in Aboriginal and Torres Strait Islander health research and the updated NHMRC (2007) National Statement of Ethical Conduct in Human Research, has evolved from a history of changing contexts in governmental and institutional policies and stronger engagement of Indigenous people in research (Anderson 2003). These guidelines explicitly acknowledge the role of research in colonisation and assimilation and the significant impact on Aboriginal and Torres Strait Islander people (NHMRC 2003:2). They urge researchers to 'make particular effort to deal with the perception of research held by many Aboriginal and Tortes Strait Islander communities as an exploitative exercise', and to 'demonstrate through ethical negotiation, conduct and dissemination of research that they are trustworthy and will not repeat the mistakes of the past' (NHMRC 2003:18).

The 2003 NHMRC guidelines have been described as an attempt to decolonise research in Australia (de la Barra 2007). They remind researchers that, first, 'failing to understand difference in values and culture may be a reckless act that jeopardises both the ethics and quality of research' and, second, that 'failing to recognise cultural difference can inflict harm, can be a form of oppression, imprisoning someone [or a group] in a false, distorted and reduced model of being' (NHMRC 2003:2). The guidelines take account of the continuing concerns of Aboriginal and Tortes Strait Islander peoples regarding 'poor consultation, lack of communication and infringement of deeply held values arising from cross-cultural insensitivity' (NHMRC 2003:4).

Further, the guidelines emphasise the need to acknowledge cultural differences and consideration of cultural values. They are based on six core values: reciprocity, respect, equality, responsibility, survival and protection, and spirit and integrity. They state that, where possible, Indigenous people should be part of the research planning, that the research should benefit the community, that Indigenous knowledge systems and processes should be respected, that Indigenous researchers and community members should be an active part of the research, and that informed understanding and consent is a necessary characteristic throughout the research project. The NHMRC's (2005) Keeping Research on Track: A guide for Aboriginal and Torres Strait Islander peoples about health research ethics is a companion resource (to the 2003 guidelines) for Aboriginal and Torres Strait Islander people when making decisions about health research in their communities. An example of such research is presented later (Case study 2) to demonstrate how these values and resources are integrated into a community-based health research study.

The Aboriginal and Torres Strait Islander Research Reform Agenda

In the early 2000s the Cooperative Research Centre for Aboriginal and Tropical Health (later the Cooperative Research Centre for Aboriginal Health (CRCAH) and, most recently, the Lowitja Institute) was established to improve Aboriginal health through effective research. Reasserting the broader agenda set at the 1986 conference, Henry and colleagues at the CRCAH called on 'researchers, research organisations, the academy, funding bodies and higher education institutions' to 'justify their involvement in Indigenous health research' (Henry et al. 2002a:4). They proposed an Indigenous Research Reform Agenda (IRRA), which recognises that radical changes are required in how Indigenous health research is approached, including the way that institutions actualise, process and monitor research (Henry et al. 2002a). Key IRRA principles advocated by Humphery (2001) include Indigenous community involvement in the prioritisation, design, execution and evaluation of research; mechanisms for Indigenous control, ongoing surveillance and transformation of research; and determination of ethical processes for the conduct of research in terms of consultation and negotiation. Other principles include:

* transformation of research practices from 'investigator-driven' to a re-assertion of control by Indigenous community-controlled organisations over the research project and an adoption of the needs-based approach to research

* linkage between research and community development and social change

* the training of Indigenous researchers

* the adoption of effective mechanisms for the dissemination and transfer of research findings

* ownership and control of research findings by Aboriginal communities (Henry et al. 2004:10).

A full discussion of the IRRA can be found in the Links Monographs (Henry et al. 2002a, 2002b, 2004). The IRRA has strong Indigenous community support and has been theorised, articulated and promoted by both Aboriginal and Torres Strait Islander representatives and their allies across a range of disciplines within higher education institutions and research organisations throughout Australia (Monk et al. 2009). An important focus of the IRRA is the formalisation of Indigenist research philosophies, principles and practices to legitimise and validate Indigenous peoples' ways and practices.

The role of human research ethics committees

Despite the sustained effort of Aboriginal and Torres Strait Islander people over a number of years and the development of Indigenous research guidelines, non-Indigenous researchers have largely retained control over the initiation, process, evaluation and dissemination of research into Aboriginal health and wellbeing. Most institutions involved with research about Aboriginal and Torres Strait Islander peoples and issues have adopted guidelines and protocols to guide research (see, for example, AIATSIS 2000; Walker et al. 2001).

However, while the Human Research Ethics Committee (HREC) system and values and ethics guidelines are valuable tools, concerns have been raised (Humphery 2002) that HRECs are not across all phases of Aboriginal and Torres Strait Islander research. Further, only 30 of 200 HRECs have Aboriginal and Torres Strait Islander members on their committees. (1) While most research institutions require evidence of consultation with relevant Aboriginal groups prior to granting ethics approval, there is concern that once a research project has received ethics approval, there are no mechanisms in place to monitor, evaluate or report on research outcomes (Dunbar et al. 2003). Several universities and research institutes are successfully addressing such concerns and adopting decolonising approaches. There are examples where Aboriginal health ethics committees and sub-committees have extended their role for the approval process to involve ongoing accountability and monitoring in line with the recommendations (Dunbar et al. 2003). There are a number of good examples of processes put in place by HRECs in universities and institutions throughout Australia in consultation with Indigenous people to address such concerns. For instance, all Aboriginal health research undertaken by staff and students at The University of Western Australia must comply with the NHMRC (2003, 2007) values and principles relating to research with Aboriginal and Torres Strait Islander people. All research proposals submitted must specifically address the six core values mentioned previously. In addition, researchers are required to submit their proposals to the Western Australian Aboriginal Health Information and Ethics Committee (WAAHIEC) for approval. In turn, WAAHIEC requires a demonstration that relevant Aboriginal groups have been consulted prior to the proposal and that processes are in place to communicate, disseminate and translate research with community involvement. There are also additional requirements to go through the Aboriginal Community Controlled Health Services in most regions. These processes are in accordance with recommendations to address the concerns outlined previously (Dunbar et al. 2003).

Part of the dilemma for researchers is that working in accordance with these values for the benefit of Aboriginal and Tortes Strait Islander people may conflict with existing mainstream funding and career expectations. Within this context, consideration needs to be given by NHMRC and other competitive research funding bodies to changing the criteria for evaluating research performance--shifting the focus away from the number of peer-reviewed journal publications to requiring researchers to provide evidence of meaningful implementation and translation of research findings into policy and practice in accordance with Indigenous research interests and priorities. A broader evaluation process is required that takes into account the research process and community perspectives of the process and the final product, since it is only after research has been conducted that researchers prove themselves trustworthy through both the process and the results they deliver to improve health and wellbeing outcomes with and for Indigenous people (Henry et al. 2002a).

Decolonising research and collaborative relationships

A paradigm shift is gradually occurring as evidenced in the work of Indigenous scholars such as Jahnke and Taiapa (1999), Martin (2008), Moreton-Robinson and Walter (2010), and Smith (1999). Collaborative and participatory research methodologies are generally identified as being compatible with the goals of the emerging Indigenous agenda for research reform in Australia and internationally. The increasing focus on bottom-up participatory approaches is seen to have come from the failure of centralised or top-down approaches to deliver sustainable improvement to the lives of Indigenous people who have been the subjects of research in a global context (Bishop 2005; Jahnke and Taiapa 1999; Smith 1999).

Tsey (2001) suggests that if research organisations are to become more relevant to the needs and aspirations of Australian Indigenous peoples, they need to enter into collaborative partnerships with Indigenous organisations and communities. He makes the point that genuine collaborative research requires time, commitment and hard work, and 'a longer term approach to Indigenous health research, including the development of strategic alliances' (Tsey 2001:23). Such an approach also requires restructuring the methodology to focus on relationship building and the research process, rather than the usual emphasis solely on outcomes. Case study 2, below, demonstrates that health research that focuses on building such partnerships at the community level can have a range of positive health impacts.

Collaborative relationships and partnerships to close the gap

Partnerships between Indigenous and non-Indigenous Australians have emerged as a key issue in government policy to 'close the gap' in Indigenous health inequality. The Close the Gap campaign launched in March 2008 and the Council of Australian Governments made a commitment to a partnership between all levels of government and Indigenous Australian communities. The aim was to close the life expectancy gap within a generation and to halve the mortality rate for Aboriginal and Torres Strait Islander children under the age of five within a decade. In Close the Gap: National Indigenous Health Equality Targets (HREOC 2008:22), this commitment includes a discrete partnership target to achieve the goal of 'Aboriginal and Torres Strait Islander community engagement, control and participation in Indigenous health policy and program development, implementation and monitoring'. These targets are the first step in a continuing process to achieve a genuine partnership between governments and Aboriginal and Torres Strait Islander and other organisations. According to the Close the Gap Steering Committee for Indigenous Health Equality (2010:4-5):

Genuine partnership exists when:
 two or more parties join together to work toward a common goal; it
 is a process of shared decision making, of negotiated outcomes, and
 of mutual respect. It is an ongoing process, and one that requires
 sustained effort to maintain over time. At its heart, working in
 partnership means that both parties have genuine influence--in
 identifying issues and developing solutions and determining the
 form of partnership.


Partnerships should be transparent and involve relevant representative bodies, acknowledge historical and current power imbalances in order to build capability and capacity for Indigenous people, and involve the review and evaluation of processes and outcomes (Close the Gap Steering Committee for Indigenous Health Equality 2010). Genuinely collaborative research relationships require mutual trust, shared resources and mutually agreed goals (NHMRC 2003, 2007).

Research collaborations may be difficult to manage in their early stages, and require considerable time and patience to establish and maintain trusting and effective partnerships to achieve the agreed research outcomes. There is increasing attention in looking at ways to build and maintain trust between research collaborations across two very different cultures and the need for specific training to encourage and sustain collaborations.

This paper now describes two examples of research undertaken through the Telethon Institute for Child Health Research in the spirit of partnership and commitment to closing the gap through Indigenous health research. The first is the Western Australian Aboriginal Child Health Survey (WAACHS), which is a comprehensive survey of Aboriginal health and social and emotional wellbeing that was undertaken in Western Australia between 2000 and 2001; the second is the Kalgoorlie Otitis Media Research Project.

Case study 1: The Western Australian Aboriginal Child Health Survey

The WAACHS is an exemplar of Aboriginal involvement in all phases of research from inception to completion (WAACHS 2007). An Aboriginal Steering Committee determined the research direction, methodology and questions, advised the training of interviewers, interpretation of results and the formulation of recommendations, and participated in the translation of the results with government and communities. The committee had responsibility to control and maintain the cultural integrity of survey methods and processes; employment opportunities for Aboriginal people; data access issues and communication of the findings to the Aboriginal and general community; and appropriate and respectful relations within the study team with participants, communities, stakeholders, funding agencies and governments. Qualitative and quantitative information was collected from more than 5000 children and families across Western Australia. The information was analysed by two working parties with majority Aboriginal members who designed and monitored the communication, dissemination and translation of findings and recommendations. A pilot study was undertaken with remote community groups using storyboards, videos, community booklets and local community profiles to determine the most effective and culturally appropriate way to communicate the information at a community level. Importantly, Aboriginal people had asked for the study to be undertaken to identify the health and wellbeing of Aboriginal children and families in Western Australia compared with the total state population. The argument presented by Aboriginal leaders at that time raises another paradox--that to not undertake research with Aboriginal people that could help to improve health outcomes can be as equally unethical as poor research.

The project conformed to requirements and protocols for health research with Aboriginal people and adhered to NHMRC ethical standards and research guidelines. It was approved by the Western Australian Department of Health's Aboriginal Health Information and Ethics Committee, as well as the Ethics Committee of King Edward Memorial and Princess Margaret Hospitals. The Aboriginal Steering Committee monitored the adherence to these standards throughout the project. In addition, two working groups had responsibility to ensure the effective and culturally responsive communication, dissemination and translation of survey results to communities and stakeholders and policy makers.

It is difficult to quantify the extent to which the WAACHS has impacted on health and wellbeing outcomes overall. However, there are numerous instances where communities have engaged in subsequent initiatives because of the WAACHS findings and recommendations and because they have 'ownership' over and confidence in the results precisely because they were aware that Aboriginal people had been extensively involved in the research from the onset.

Case study 2: The Kalgoorlie Otitis Media Research Project: ethical considerations

There had been a call from the community for a study such as the Kalgoorlie Otitis Media Research Project: people were concerned about the potentially negative impact of Otitis Media (OH) on children's wellbeing, in particular on their school performance. The co-ordinator (Elsie Edwards) of Ngunytju Tiitji Pirni Inc. (NTP, an Aboriginal Health Service) was chief investigator on the first grant application in 1997 and Aboriginal investigators were part of subsequent funding applications. Formal collaboration with Bega Garnbirringu Health Service Aboriginal Corporation (BEGA) was established in 1999. When learning that BEGA had limited access to ear, nose and throat (ENT) specialists, the NTP's ENT specialist offered his services at no cost until another specialist became available. The NTP also assisted BEGA in obtaining funding for an Ear Health Worker and offered parents and children transport to ENT clinics.

People were informed about the study through radio and television interviews, newspaper articles and face-to-face discussions. Aboriginal and non-Aboriginal people provided input into the study design and content of information sheets, consent forms and questionnaires, which were developed in line with routine data collection instruments used by NTP. All research staff pretested all forms and piloted specimen collection among themselves. This meant they could explain to future participants what discomfort children might experience.

Meetings were held with local medical practitioners to explain the purpose of the study, to ask them to encourage their clients to take part in the study and to seek their approval to access participants' medical records. After 12 months of developing partnerships with local organisations and health professionals, the study was endorsed by the relevant local Aboriginal organisations, leading to approval from WAAHIEC to conduct the study.

The research assistants were Aboriginal Health Workers (AHWs) and nurses who were well known to the local community. Nurses and AHWs gained experience in research and played an active role in the local Ear Health Committee, which aimed to increase awareness about OM and develop programs to improve ear health. Being enthusiastic about the project themselves, research assistants were able to encourage others to participate in the study (Lehmann et al. 2007:62-3).

The importance of being critically reflective of one's own practice is essential when working, or undertaking research, in cross-cultural contexts to ensure that researchers adhere to ethical guidelines for working in Indigenous contexts (Walker and Sonn 2010). Lehmann et al. (2007) took on this challenge in their own practice in the Kalgoorlie OM study. They posed the question, 'How successful were we in conducting this study in line with the ethical guidelines available during the planning and recruitment phases of the study and did we meet up to the more recent criteria and values specified in the 2003 guidelines?' (Lehmann et al. 2007). Their reflection on this topic is summarised in the following quote:

On reflection the study team believed that they were successful in following the NHMRC guidelines; they developed good partnerships with local communities, and participants actively participated in the research from the outset. They closely adhered to the guidelines regarding consent, confidentiality and acknowledgement of investigators and participants. Even so they felt that they should have consulted more widely with the communities when planning the study (Lehmann et al. 2007:68).

They believed the 'research was potentially useful to the community' as local community members had expressed their concerns about OM and its consequences. Reduction in the burden of OM would improve survival of Aboriginal people as improved hearing leads to better educational outcomes and quality of lift. While members of the Aboriginal community were participants from the start, it took more than one year to develop the research protocol. While it took much longer than planned for Aboriginal organisations to consider all aspects of the study, the team members acknowledged that their input and sense of ownership contributed to its overall success. Aboriginal organisations assigned health workers to the project, participated in focus groups, and wore T-shirts designed as part of a health awareness campaign aimed at reducing smoking and enhancing breast feeding.

The project team developed strong partnerships, respectful research relationships to achieve equality, by including all stakeholders in the planning process and providing them with regular progress reports. They planned follow-up visits so that they would not be too disruptive to people's lives and ensured reciprocity in the research by providing hearing screening to all newborns and the pneumococcal conjugate vaccine (Prevenar[TM]) to non-Aboriginal children (who were not generally eligible for this at the time) and regular ENT follow-up to study participants and their families, and arranged prompt surgical intervention if required. ENT specialist services continue and a hearing screening program is being developed as a consequence of the study.

In the spirit of developing true partnerships, AHWs were initially seconded from NTP or BEGA to work part-time on the project. However, they frequently had other commitments and it was only when there were sufficient funds to employ a dedicated research assistant, Annette Stokes, that recruitment of Aboriginal babies increased and follow-up was more successful. Annette was supported by the community to take on the cultural and spiritual responsibility to ensure the success of the project. The Aboriginal staff provided cultural security for the study, linking non-Aboriginal investigators with the Aboriginal community and increasing their understanding of how children were living with OM.

The team took responsibility to maintain confidentiality and to present results to the local community before publishing or presenting them outside the local community. The team provided feedback on the progress and results of the study to the community, study participants and service providers during local social activities and National Aboriginal and Islander Day Observance Committee week celebrations and through newsletters. Steps to transfer the research results using community-based health promotion and preventative strategies have been undertaken with the community to reduce OM within the community (Lehmann et al. 2007:68).

The reflections by Lehmann et al. (2007) on their study confirm that using community participatory action research and adhering to participatory and ethical practice not only increases the likely success of the process but increases the likely improvements in health outcomes. Both case studies demonstrate how engaging in early and ongoing consultation contributes to community ownership, and greater uptake, of research findings and hence greater potential to improve health outcomes. Both studies established Aboriginal reference groups, factored in funding and time to develop partnerships and to ensure Aboriginal participation in all phases of the research, developed processes to ensure confidentiality of information and Aboriginal control of the dissemination, communication and translation of results and management of access to data, and included appropriate acknowledgment of all Aboriginal contributions.

These case studies show that it is possible to adopt a decolonising approach to Indigenous health research through a commitment to translating the results at both policy and local community levels to support Aboriginal priorities and interventions to improve health outcomes. In summary, these case studies confirm that, despite the many constraints and contextual challenges, it is possible to conduct rigorous research in genuine partnership with Aboriginal communities and organisations in order to improve health outcomes that meet Aboriginal priorities.

Developing culturally competent researchers

Research has been a powerful part of the colonisation of Indigenous peoples throughout the world. In Australia Indigenous academics including Martin (2008), Moreton-Robinson (2004), Nakata (2007), Oxenham (1999) and Rigney (1997, 1999) have raised concerns about ownership of Indigenous knowledges and the role of research in the process of colonisation. They urge Indigenous Australians to critically engage in developing an indigenist research agenda and emancipatory research methodologies as part of that engagement. Rigney (1999:114) summarised these concerns:
 Indigenous Peoples must look to new anti
 colonial epistemologies and methodologies
 to construct, rediscover, and/or reaffirm their
 knowledges and cultures. Such epistemologies
 must represent the aspirations of Indigenous
 Australians and carry within them the potential
 to strengthen the struggle for emancipation
 and liberation from oppression.


Oxenham (1999) outlines the core values of Aboriginal terms of reference as the right of expression of Indigenous realities through the processes of deconstruction and reconstruction. Implicit in this is the view that Aboriginal people have the right to 'speak back' to the historical and contemporary (mis)constructions about themselves and their culture. As well as Aboriginal and Torres Strait Islander attempts to reclaim and reposition the representation of Indigenous cultures in their work, in an effort to re-set the nature and intent of their relationships with Indigenous peoples, non-indigenous scholars need in examine the concepts of whiteness/power and decolonisation, as well as the more common understandings of discrimination, the contribution of research to Indigenous disadvantage, strategies to re-position and support Indigenous initiated and led research, and how they might contribute to Aboriginal and Torres Strait Islander self-determination.

Dunbar et al. (2003:13) caution that collaborative research methodologies 'are always activated within institutional contexts with their attendant political and ideological underpinnings', and 'without a critical awareness ... the liberating potential of the adopted research methodologies may be diminished as the "research-in-practice" defaults to the desires of the most powerful'. They suggest the difficulties in establishing and maintaining cross-disciplinary research teams highlight the need for careful preparation and a commitment to privileging Indigenous voices in multi-disciplinary research teams.

Conclusion

Historically, Indigenous health research, and especially epidemiological studies, have reflected the interests of the dominant population. Despite their geographical and cultural diversity, key indicators of Indigenous population health have been aggregated and reported in largely descriptive and comparative terms which have not necessarily served the interests of Aboriginal and Torres Strait Islander people. Until recently, very little research has been undertaken to understand the complex, multifaceted social determinants that influence Indigenous health and wellbeing outcomes. Increasingly, however, through the work of the CRCAH, NHMRC and the WAACHS discussed in the paper, the growing body of Indigenous research shows that culturally responsive and inclusive methodologies and approaches to research which engage Aboriginal people as active partners in the research can result in greater uptake of research findings and greater capacity and knowledge of Aboriginal communities about the relevance and value of the research.

It is also recognised that research and evaluations of interventions and programs that are working to address Aboriginal health and wellbeing questions are essential to closing the gap (Campbell et al. 2007). This requires researchers who are competent to work in multidisciplinary teams and in partnership with culturally diverse populations. The increasing understanding of the need to involve Aboriginal people in setting the research questions and interpreting the results offers new and exciting possibilities for future partnerships and ethical practice (Dunbar et al. 2003).

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Pat Dudgeon

School of Indigenous Studies, The University of Western Australia

Kerrie Kelly

Australian Indigenous Psychologists Association

Roz Walker

Centre for Child Development, The University of Western Australia, and Telethon Institute for Child Health Research

NOTE

(1.) For a full list of HRECs, see the 'Ethics committees' page of the Indigenous Health Ethics Network website at <www.indigenoushealthethics.net.au/ hrec>.

Dr Pat Dudgeon is descended from Bardi people of the Kimberley in Western Australia. As well as leadership in Indigenous higher education, she has had significant involvement in psychology and Indigenous issues for many years. She has many publications in this area and is considered one of the 'founding' people in Indigenous people and psychology. She is the current Chair of the Australian Indigenous Psychologist's Association and a member on the Public Interest Advisory Group of the Australian Psychological Society (APS), and was awarded the grade of Fellow in the APS in 2008. Currently, she is a research fellow and an associate professor at The University of Western Australia, undertaking post-doctoral research examining contemporary Aboriginal women's roles and leadership. Her key publications include Working Together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice (2010) and Working With Indigenous Australians: A handbook for psychologists (2000).

<pat_dudgeon@optusnet.com.au>

Kerrie Kelly is a psychologist who has worked at a national level in the area of rural, remote and Indigenous health for more than a decade. Her main focus has been on workforce sustainability and the development of population health models to prevent job-related trauma and burnout among remote health practitioners, including Indigenous health practitioners. Kerrie is one of a small number of psychologists who has been mentored by Indigenous Elders to develop cultural competence in the area of social and emotional wellbeing, including the impact of forcible removal (the Stolen Generations). Currently she is the Project Officer for the Australian Indigenous Psychologists Association. She was the key researcher and lead author of a discussion paper with P Dudgeon, B Glaskin and G Gee, Living on the Edge: Social and emotional wellbeing and risk and protective factors for serious psychological distress among Aboriginal and Torres Strait Islander people (2009).

<KerrieAKelly@bigpond.com>

Associate Professor Roz Walker has more than 25 years of experience as a researcher and educator working with Aboriginal communities, building local capacity within both Aboriginal and non-Aboriginal organisations. She has worked in Aboriginal education in teaching, curriculum development, academic co-ordination, research and evaluation. She has extensive experience in translating research into policy and practice. Most recent examples include her involvement in communicating and disseminating the Western Australian Aboriginal Child Health Survey through Western Australia to communities and key stakeholder groups and implementing the Australian Early Development Index across the Pilbara. A key project has been the Staying on Track substance use reduction project funded through BHP Billiton Iron Ore Health Partnership with Telethon Institute for Child Health Research (TICHR). Roz recently co-edited and contributed to a book, Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice (2010). Roz Walker is a Chief Investigator on an NHMRC Centre for Research Excellence in Aboriginal Health and Wellbeing at TICHR. Her main areas of interest include community-based participatory action research and cultural competence.

<rozw@ichr.uwa.edu.au>
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Author:Dudgeon, Pat; Kelly, Kerrie; Walker, Roz
Publication:Australian Aboriginal Studies
Geographic Code:8AUST
Date:Sep 22, 2010
Words:6363
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