Purpose To inform the development of the South Australian Aboriginal Ageing Well Roadmap, this study aimed to understand the priorities, enablers and strategies for ageing well from the perspective of Aboriginal and Torres Strait Islander community members and cross-sectoral stakeholders in South Australia. Methods This study followed a community-based participatory action research approach including community consultations with Aboriginal and Torres Strait Islander community members and a World Café with cross-sectoral stakeholders. Data collection took place between June 2024 and July 2025. Data were analysed using reflexive thematic analysis. Main findings In total, 55 community members and 16 cross-sectoral stakeholders participated in this study. Drawing together community, service and system perspectives, the findings revealed alignment in how ageing well is conceptualised, with differences in emphasis. Community members highlighted relationships and connections to Country, culture and family, while stakeholders emphasised the policy and system contexts that shape these experiences. Overall, ageing well is understood as a cumulative, relational process shaped across the life course by sovereignty, culture, rights, social conditions and system design. Principal conclusions Improving ageing outcomes for Aboriginal and Torres Strait Islander Peoples cannot rely on uniform solutions. Effective change depends on locally grounded, community-led responses that are supported by coordinated state and system-level reform addressing the social, cultural and structural drivers of ageing across the life course. The South Australian Aboriginal Ageing Well Roadmap will provide a necessary framework to guide sustained Aboriginal-led action across research, policy and practice.
Purpose Few studies involving First Nations Peoples have explored experiences of family violence drawing on Indigenous standpoints. Little is known about the impact of family violence on Indigenous women’s psychological wellbeing or their experiences as mothers. This study aimed to explore the extent to which cultural, community and relational strengths support the psychological wellbeing of Aboriginal and Torres Strait Islander women experiencing family violence and other social health issues. Methods Data were drawn from the first two waves of the Aboriginal Families Study, a prospective cohort of 344 Aboriginal families in South Australia. Women’s experiences of family violence within family, kinship or community networks were assessed using a study designed measure. Access to cultural, community, and relational strengths and resources was assessed using the Aboriginal Resilience and Recovery Questionnaire, and psychological wellbeing using the Kessler-5 scale. Main findings More than one in three women in the cohort experienced family violence during pregnancy (37.1%), and a similar proportion when the study children were aged 5 to 8 years (36.9%). High psychological distress (Kessler-5 ≥ 11) at 5 to 8 years postpartum was more common among women experiencing family violence during pregnancy (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.3–4.9) and those experiencing concurrent family violence (OR 2.8, 95% CI 1.4–5.3). Women with lower access to cultural, community and relational strengths and resources at 5 to 8 years postpartum had almost six times the odds of experiencing high psychological distress (Adjusted OR 5.8, 95% CI 2.2–15.5). Among women who experienced family violence during pregnancy, those with greater access to cultural, community and relational strengths and resources were substantially less likely to experience high psychological distress than those with less access (Chi Square for trend 9.38; P = .002). Principal conclusions Collectively, these findings point to the need for coordinated efforts to strengthen holistic primary healthcare, practical support and healing pathways for women and families impacted by family violence within family, kinship and community networks. Aboriginal-led programs supporting women and families to have greater access to cultural, community and relational strengths and resources have the potential to act as both a preventive strategy and as a pathway for healing. There is an urgent need to expand such programs and develop meaningful change and impact goals that disrupt cycles of intergenerational trauma and family violence, by providing pathways for healing at an individual, family and community level.
Purpose Aboriginal and Torres Strait Islander trans and gender diverse people (gender diverse mob) are included in some health and wellbeing research; however, they are often a small group within a larger sample of cisgender lesbian, gay and bisexual people. This study addresses this gap by examining gender diverse mob’s mental health, social determinants of health and access to healthcare services. Methods This cross-sectional study used data collected in May 2024 for the TRANSform survey. It calculated the number and proportion of Aboriginal and/or Torres Strait Islander gender diverse participants by mental health, social determinants and healthcare access. Main findings Overall, 33 (4.1%) of the sample were gender diverse mob. Most participants (87.9%) were under the age of 55 years and 63.6 per cent were living in an urban area. Many respondents had completed tertiary education (46.1% had a tertiary level education) but low levels of employment (56.3% had employment). In the previous 12 months, 66.7 per cent experienced food insecurity and 69.7 per cent experienced housing insecurity. Most experienced trans-related discrimination from a healthcare professional (78.8%) and 54.5 per cent delayed accessing healthcare in the previous 12 months due to anticipated discrimination from healthcare providers. Many respondents experienced mental health distress, 69.7 per cent had clinical symptoms of anxiety and 69.7 per cent had clinical symptoms of depression. In the previous 12 months, 36.4 per cent had hurt themselves on purpose, 39.4 per cent had seriously considered attempting suicide and 6.1 per cent had attempted suicide. Over half (60.6%) had attempted suicide during their lifetime. Principal conclusions Many gender diverse mob have completed tertiary education, positive workplace experiences and positive connections online. However, the gender diverse mob in this study experienced high levels of mental health distress, food insecurity, suicidality, self-harm, unemployment and healthcare discrimination.
This Research Note provides an insight into research conducted in Central Australia from my perspective as an Arrernte woman communicating and engaging with Aboriginal liaison officers, Aboriginal patients and staff at Alice Springs Hospital. This paper presents my own cultural worldview, in everything I do, every day. It encompasses intricate layers of values, principles and Indigenous standpoint representing profound connections to Country and culture. It presents my reflections on relationship and kinship networks and on behaviours of each Aboriginal person. Such an approach allowed me to apply the critical first steps of engagement that include the rules, boundaries and protocols of Aboriginal communication. Much of the research approach was based on Akangkwe-irreme (a concept of Arrernte peoples about listening deeply to story) as told by Eastern Arrernte Elder, Mrs Kathleen Wallace.
This study addresses the disproportionate incarceration of Aboriginal and Torres Strait Islander children in Australia by co-designing an Indigenous community-led, culturally responsive prevention framework. Building on three prior studies – a scoping review and two qualitative studies with Elders, community members, and children – the research employed an iterative co-design process grounded in Indigenist and decolonising methodologies. Participants engaged in single and group yarning interviews to refine framework components, ensuring alignment with cultural values and community priorities. The resulting framework, Transformative healing and Adungadoo pathways, comprises three interconnected levels: universal outcomes for thriving children, connected families and empowered communities, rights-based systemic reforms, and culturally grounded program elements across the life course. Findings highlight the need for holistic, healing-informed and strengths-based approaches that disrupt colonial drivers of child incarceration and promote self-determination. This work offers a practical, community-driven model for justice reinvestment and systemic transformation.
For Indigenous Peoples globally, place is more than physical geography. It represents a nexus of spiritual, ecological, and social relations rooted in cultural memory and historical contexts. These dimensions make place an essential yet often overlooked determinant of health and wellbeing. Our team of health researchers, working at the cultural interface, sought to understand how Place shapes approaches to brain ageing with Aboriginal and Torres Strait Islander Peoples. Within this broader context, the team engaged in collaborative yarns, an Indigenous methodology grounded in relationality, to explore how health research with Indigenous Peoples can operationalise Place. A key finding was the pivotal role of the Navigator, a trusted community member whose Place-based knowledge guides the research team, safeguards Indigenous sovereignty, and ensures cultural integrity. The Navigator affirms Indigenous ways of Knowing, Being, and Doing, bridging Community and researchers while upholding the primacy of Place in interpreting shared knowledge. When health research centres Place, it gains cultural and contextual validity, enabling more meaningful knowledge translation. This approach strengthens trust and reciprocity and offers pathways for policy and practice that are responsive to Community priorities, advancing more equitable and grounded models of brain health.
Purpose: Aboriginal and Torres Strait Islander Peoples (hereafter First Peoples) define health and wellbeing as grounded in Country, yet institutionalised national health systems in Australia rarely recognise or resource cultural medicines. Cultural medicines, such as smoking ceremonies, being on Country, and engagement with traditional healers are central to health sovereignty; however, most research has examined traditional, complementary and integrative medicines without focusing on cultural medicines or equity of access. This study reports the first Australia-wide exploratory survey of cultural medicines utilisation, access and intention to use among First Peoples in Australia. Methods: This exploratory, cross-sectional study formed part of a national co-design project on cultural medicines in healthcare. A co-design research group adapted the I-CAM-Q instrument to reflect cultural medicines using iterative, culturally governed co-design. An online survey of First Peoples aged 18 or more years was disseminated through the co-design research group's networks and social media between December 2023 and January 2024. Demographic characteristics and responses on utilisation, access and desire to use cultural medicines were analysed descriptively, with attention to unmet needs and access barriers, and interpreted as exploratory, given the likely under-representation of older knowledge holders, men and people in remote communities. Main findings: A total of 186 First Peoples adults participated (81.7% female; predominantly aged 30–49 years). Demand for cultural medicines was high but access was limited. Only 9.7 per cent reported easy access to traditional healers, yet over 94 per cent of those without access indicated that they would use healers if available. Use of Country as medicine and smoking ceremonies were most common, while song-based ceremonies, insect-based native foods and traditional healers showed lowest engagement. Respondents preferred accessing cultural medicines through Aboriginal community-controlled health services. Most wanted family members to have access to healing ceremonies for grieving as part of their end-of-life care (i.e. palliative care). Only a small minority did not want access to cultural medicines. Principal conclusions: Cultural medicines remain a critical yet under-supported health practice for First Peoples in Australia. Despite limited access, these findings demonstrate strong intent to use cultural medicines and unmet need linked to structural barriers in the health system. Ensuring health equity requires culturally safe healthcare models that respect and integrate cultural medicines under First Peoples’ governance, supported by policy frameworks that protect Indigenous knowledges and uphold health sovereignty and Indigenous rights.
Purpose As in all colonised nations, Aboriginal and Torres Strait Islander children and young people face higher rates of mental health challenges and medical conditions than non-Indigenous youth. Strengthening cultural safety in healthcare services is increasingly being recognised as essential to addressing these disparities and improving service delivery. This rapid review sought to synthesise existing evidence on the components of culturally safe healthcare for Aboriginal and Torres Strait Islander children and young people aged 0 to 25 years. Methods PubMed, Web of Science, Embase, PsycINFO, CINAHL and ATSIHEALTH were searched to identify peer-reviewed articles published up to November 2024. Eligible studies explored characteristics of culturally safe health services from the perspectives of service users (Aboriginal and Torres Strait Islander children and young people aged 0 to 25 years), their families and Indigenous staff within these services. The quality of included studies was assessed using the Aboriginal and Torres Strait Islander Quality Appraisal Tool, and thematic synthesis was used to develop themes. Main findings Twenty studies were included in the review. Six themes were identified. Cultural safety in healthcare requires culturally responsive communication and a capable, well-supported workforce that includes Aboriginal and Torres Strait Islander staff at all levels. Care must centre families and communities, acknowledging and embedding kinship systems and cultural values. Strong Indigenous governance and service-led community engagement are essential. While representations of culture in service environments are essential, true cultural safety requires integrating Aboriginal and Torres Strait Islander knowledges and healing practices throughout care. Principal conclusions The findings highlight the critical role of a capable and culturally responsive workforce and visible representations of culture in healthcare settings to foster safety. These efforts must be complemented by broader service-level and system-level reforms that formalise cultural governance, embed Aboriginal and Torres Strait Islander cultural values, and deliver care that is responsive to the strengths and needs of families.
Purpose This systematic review sought to highlight positive aspects, strengths and successful outcomes of mental health interventions and psychological therapies for First Nations peoples, by identifying and evaluating culturally tailored, strengths-based approaches that foster conducive healing experiences. By assessing and synthesising existing studies that report positive healing outcomes for First Nations peoples in Australia, this review informs clear proposals and suggested adaptations to policy, planning and service provision within the current mental healthcare system. The central question was: What is the effectiveness of culturally tailored, strengths-based mental health interventions for promoting positive healing experiences among First Nations peoples of Australia? Methods Following Joanna Briggs Institute methodology for systematic reviews of effectiveness, a comprehensive analysis was undertaken of both quantitative and qualitative studies. Due to qualitative diversity and limited comparability, a meta-analysis was unfeasible, and a narrative synthesis was used to capture key findings. Main findings Eleven studies met the inclusion criteria, with most demonstrating favourable outcomes; two studies reported inconclusive or mixed findings for some evaluation measures. The quantitative findings demonstrate that integrating cultural elements into psychological interventions leads to meaningful outcomes across a range of mental health measures. Four core themes were identified following an analysis of both quantitative and qualitative findings: Connection to Country, Cultural practices and safe spaces, Creative expression and holistic approaches, and Therapeutic interventions and program acceptability. These results underscore the importance of culturally inclusive environments that facilitate healing and wellbeing, whilst also highlighting the crucial role of Indigenous-led programs and services in fostering healing among First Nations peoples in Australia. Principal conclusions Incorporating traditional cultural practices and creative expression strategies into mental healthcare delivery is integral to promoting positive, holistic wellbeing. By ensuring culturally safe spaces, individuals, families and communities are better supported in processing past experiences, fostering reparation and healing. Although there are few studies, this creates future opportunities for Indigenous-led programs that focus on conducive healing for First Nations peoples. This study highlights the need for further research that includes published evaluations of culturally tailored psychological interventions.
Purpose The Aboriginal-led Healing the Past by Nurturing the Future project was conceptualised to co-design safe, acceptable and feasible strategies for supporting Aboriginal and Torres Strait Islander parents experiencing complex trauma in the perinatal period. Six strategies have been co-designed to increase complex trauma awareness amongst both parents and service providers in perinatal health settings: three resources for Aboriginal and Torres Strait Islander parents, alongside three training courses designed for perinatal service providers. This paper reports on the perceived acceptability and usefulness of the proposed project strategies from the perspectives of parents and service providers who participated in a series of national in-person discussion groups, as well as key stakeholders of a Victorian pilot implementation site who participated in an online workshop. Methods Using a participatory action research approach, 21 Aboriginal parents participated in six discussion groups; and 20 service providers (seven Aboriginal; 13 non-Indigenous) participated in four discussion groups in 2022 in the Northen Territory, South Australia and Victoria. Fifty-seven key implementation site stakeholder participants attended the online workshop held in 2022. Most participants were from Victoria (56%) and South Australia (18%). Just under half of the participants identified as Aboriginal and/or Torres Strait Islander. Data were compiled and thematically analysed by Aboriginal and Torres Strait Islander and non-Indigenous researchers. Main findings Four major themes were generated from the discussion group and workshop data: 1) Who gets to tell the story on trauma? Doing it the right way for every community; 2) Listening to unlearn; decolonising practice in perinatal settings; 3) A two-way learning opportunity about parenthood beyond trauma; and 4) Strength in culture; ensuring cultural and emotional safety of parents through strengths-based approaches. Principal conclusions The research findings reflect established principles for researching and implementing programs designed for and by Aboriginal and Torres Strait Islander communities, emphasising community ownership, contextual relevance, cultural safety and shared learning. The findings have been used to inform the co-design and dissemination of resources; identify barriers and facilitators to project implementation; and to inform future evaluation of complex trauma awareness resources for Aboriginal and Torres Strait Islander parents, with a focus on the perinatal period.
This discussion paper outlines the process undertaken by the School of Nursing, Midwifery and Social Work to establish an Aboriginal and Torres Strait Islander advisory panel (AP). Guided by the School’s strategic commitment to fostering two-way learning between Aboriginal and Torres Strait Islander Peoples and non-Indigenous staff, students and community members, the initiative explored the potential of an Elder in Residence role. Strategic funding enabled a roundtable discussion with Aboriginal and Torres Strait Islander nurses, midwives and social work practitioners, who provided critical insights into the preferred structure and purpose of such a role. Participants advocated for an AP, rather than a single Elder in Residence, to reflect the diversity of disciplines within the School. The formation of the AP represents a meaningful step towards decolonising education and research. It embeds First Nations authority, supports ethical research practices and reorients the epistemological foundations of nursing, midwifery and social work to honour Aboriginal and Torres Strait Islander ways of knowing, being and doing.
Purpose: BlaQ people11 Refer to the section titled The term ‘BlaQ’ for an explanation of the use of the term. and communities face intersecting, multiple and compounding discrimination, which impacts BlaQ social and emotional wellbeing, and family, community and Country connections. BlaQ perspectives and lifeworlds are excluded in current cultural, social and political determinants of health domains, understandings and Indigenous wellbeing models. Self-determining rights of BlaQ peoples are limited as there is no treaty or convention that specifically focuses on the rights of BlaQ peoples. A preliminary model has been proposed for understanding and advancing the cultural, social and political determinants of health for BlaQ identifying people and the benefits it may bring for BlaQ self-determination and health and wellbeing. Methods: A Queer Indigenous standpoint theoretical framework was used, and a critical and reflexive literature review and thematic analysis that prioritised BlaQ scholarship was used to create the preliminary BlaQ cultural, social and political determinants domains and their benefits for self-determination. Main findings: A preliminary model for BlaQ cultural, social and political determinants domains has been proposed that centres the concept that BlaQ strong culture and health is enabled when cultural, social and political determinants are interconnected. This review and analysis demonstrated that the model has multiple benefits for BlaQ self-determination and can provide a preliminary model for action for BlaQ health justice, equity, safety and inclusion. Principal conclusions: The model provides a preliminary approach to understanding and addressing health determinants for BlaQ people and communities. Future research is required to further consider the model and its potential application.
This study evaluated a health and wellbeing program for First Nations girls and young women implemented by an Aboriginal community-controlled health organisation. The evaluation used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework.In-depth, semi-structured interviews were conducted with 39 key informants, including program participants and implementers. The program reached 59% of the target group. The design and implementation were grounded in Indigenous philosophies of collective and relational flourishing. Through participation, individuals strengthened connections and established trusting relationships. Storytelling and yarning enabled participants to locate themselves in an ongoing narrative that mapped their family and community history. Schools with aspirations aligned with the program goals adopted it, although implementation was hampered by COVID-19 restrictions. The program applied a sophisticated understanding of strengths-based practice, relationality, and the role of resistance and resilience to meet the participants’ needs.The evaluation provides evidence supporting the effectiveness of the program and highlights the factors contributing to its success. The findings highlight that effective programs for young women in urban settings embed connection to culture and identity at their core. It illustrates the value of Aboriginal community-controlled service delivery. When implementing or funding similar programs, two main insights should guide decisions. Firstly, the focus must be on cultural continuity and empowerment. Secondly, success depends on removing practical barriers and engaging participants through interactions that are affirming, fun and inspiring.The leadership and knowledge of Aboriginal collaborators throughout the research and writing process were key to producing a rigorous and relevant evaluation.
Purpose Evidence suggests that patient navigators (PNs) can improve patient engagement, emotional wellbeing and clinical outcomes. This study explored how PNs influence the care experiences of Aboriginal and Torres Strait Islander peoples living with kidney failure, from the perspectives of patients and health service staff. Methods Qualitative data were collected through kidney journey mapping and yarning interviews across four kidney health services employing PNs in the Northern Territory and South Australia. Data were thematically analysed to understand patient care experiences with and without PN support. Main findings Patients reported challenges around inadequate communication, difficulty accessing appropriate services and support, poor cultural safety, and the emotional toll of treatment. Support included family and patient networks, positive relationships with health staff, and holistic models of care. PNs played a supportive role by sharing their kidney journey experiences, providing cultural connection, peer support and bridging systemic gaps. Principle conclusions PNs strengthened patient care experiences by addressing service gaps, improving cultural support and sharing from lived experience. Embedding PNs into standard kidney care is a critical step toward achieving culturally safe, equitable and responsive health systems.
Purpose Culturally safe care in neonatal intensive care units (NICUs) is crucial for Aboriginal and Torres Strait Islander infants and their families. Despite national efforts to improve culturally safe care, there is inconsistency in the way that health practitioners engage and translate cultural safety into their clinical practice. Currently, there is limited literature on Aboriginal and Torres Strait Islander health in NICUs to inform evidence-based practice. This study sought to explore health practitioners’ knowledge, attitudes and practices in delivering culturally safe care to Aboriginal and Torres Strait Islander infants and families in NICUs. Methods This paper presents the qualitative findings of an online, cross-sectional, descriptive survey conducted with health practitioners from two New South Wales NICUs. Two open-ended questions were thematically analysed. A total of 164 complete open-ended responses were provided for question one and 103 for question two. Participants were recruited via flyers located in participant workspaces over a six-month period. Main findings Five themes were identified. Theme one: Staff are aware of the term cultural safety and their role in delivering culturally safe care. Theme two: Staff lack confidence and find it difficult to deliver culturally safe care. Theme three: Truth telling: culturally safe care is not always upheld in practice. Theme four: Education is important, but staff want experiential learning to be able to enact cultural safety in practice. Theme five: Systemic change is necessary: policies and guidelines need to be created, and Aboriginal leadership needs to be prioritised. Principal conclusions Health practitioners in NICU settings have reported a lack of confidence and support to deliver culturally safe care to Aboriginal and Torres Strait Islander infants and their families. This study highlights the need for experiential learning, face-to-face education, and an increase in representation of Aboriginal and Torres Strait Islander leadership in health services. Further research is recommended at both a local and national level to inform policy and practice of culturally safe care in NICUs.
