Aboriginal Medical Service Western Sydney

Mount Druitt, Australia

Aboriginal Medical Service Western Sydney

Mount Druitt, Australia
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PubMed | University of New South Wales, Victorian Aboriginal Community Controlled Health Organisation, La Trobe University, Aboriginal Medical Service Western Sydney and 4 more.
Type: Journal Article | Journal: Drug and alcohol review | Year: 2016

To examine patterns of illicit drug use among Australian Indigenous young people, identify correlates of frequent use separately in urban, regional and remote settings and characterise those who inject.Cross-sectional design at 40 Indigenous events. Self-complete surveys were administered to Indigenous people aged 16-29 years using mobile devices.2,877 participants completed the survey. One in five reported using cannabis at least weekly in the previous year, but the use of other drugs was less prevalent. Patterns of drug use were largely similar across regions, although more participants in urban and regional areas reported using ecstasy (12% vs 11% vs 5%) and cocaine (6% vs 3% vs 1%) and more reported weekly cannabis use (18% vs 22% vs 14%). Injecting was rare (3%) but those who did inject reported a high incidence of needle sharing (37%). Methamphetamine (37%), heroin (36%) and methadone (26%) were the most commonly injected drugs, and injecting was related to prison experience (AOR 5.3 95% CI 2.8-10.0).Attention is needed in relation to cannabis use, particularly among those Indigenous young people living in regional and urban settings. Also, although injecting is uncommon, it is associated with prison involvement. Priority must be given to reducing the numbers of Indigenous youth entering justice settings, delaying the age at first entry to justice settings, and reducing the risk of BBV acquisition while in custody through, for example, prison-based NSP, BBV education, and Indigenous-specific treatment that emphasises connection to country and culture. [Bryant J, Ward J, Wand H, Byron K, Bamblett A, Waples-Crowe P, Betts S, Coburn T, Delaney-Thiele D, Worth H, Kaldor J, Pitts M. Illicit and injecting drug use among Indigenous young people in urban, regional and remote Australia. Drug Alcohol Rev 2016;35:447-455].


Digiacomo M.,University of Technology, Sydney | Digiacomo M.,Curtin University Australia | Davidson P.M.,University of Technology, Sydney | Abbott P.,Aboriginal Medical Service Western Sydney | And 6 more authors.
International Journal for Equity in Health | Year: 2013

Introduction. Aboriginal and Torres Strait Islander children have higher rates of disability than non-Indigenous children and are considered doubly disadvantaged, yet there is very little data reflecting prevalence and service access to inform design and delivery of services. Failing to address physical, social, and psychological factors can have life-long consequences and perpetuate longstanding health disparities. Methods. A narrative literature review was undertaken to identify peer reviewed literature describing factors impacting on the prevention, recognition, and access to support and management of disability in Indigenous Australian children. Results: Twenty-seven peer-reviewed journal articles met inclusion criteria. The majority of articles focused on the hearing loss and learning disabilities consequent of otitis media. Few articles reported data on urban or metropolitan Indigenous populations or described interventions. Individual/community-, provider-, and systems level factors were identified as impacting on recognition and management of disability in young Indigenous children. Conclusions: Given the burden of childhood disability, the limited literature retrieved is concerning as this is a barometer of activity and investment. Solutions addressing childhood disability will require collaboration between health, social and educational disciplines as well as an increased investment in prevention, identification and promotion of access. © 2013 DiGiacomo et al.; licensee BioMed Central Ltd.


Digiacomo M.,University of Technology, Sydney | Delaney P.,Aboriginal Medical Service Western Sydney | Abbott P.,Aboriginal Medical Service Western Sydney | Abbott P.,University of Western Sydney | And 3 more authors.
BMC Health Services Research | Year: 2013

Background: Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods. Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results: Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions: Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of considerations to address provision of disability services in an urban Australian Aboriginal community including building expertise and specialist capacity within Aboriginal Health Worker positions and services. Increasing awareness of services, facilitating linkages and referrals, eliminating complexities to accessing support, and working with families and Aboriginal community organisations within a framework of resilience and empowerment to ensure a relevant and acceptable model are necessary steps to improving support and care for Aboriginal children with a disability. © 2013 DiGiacomo et al.; licensee BioMed Central Ltd.


DiGiacomo M.,University of Technology, Sydney | DiGiacomo M.,Curtin University Australia | Davidson P.M.,University of Technology, Sydney | Davidson P.M.,Curtin University Australia | And 5 more authors.
International Journal of Environmental Research and Public Health | Year: 2011

Indigenous people throughout the world suffer a higher burden of disease than their non-indigenous counterparts contributing to disproportionate rates of disability. A significant proportion of this disability can be attributed to the adverse effects of smoking. In this paper, we aimed to identify and discuss the key elements of individual-level smoking cessation interventions in indigenous people worldwide. An integrative review of published peer-reviewed literature was conducted. Literature on smoking cessation interventions in indigenous people was identified via search of electronic databases. Documents were selected for review if they were published in a peer-reviewed journal, written in English, published from 1990-2010, and documented an individual-level intervention to assist indigenous people to quit smoking. Studies that met inclusion criteria were limited to Australia, New Zealand, Canada, and the USA, despite seeking representation from other indigenous populations. Few interventions tailored for indigenous populations were identified and the level of detail included in evaluation reports was variable. Features associated with successful interventions were integrated, flexible, community-based approaches that addressed known barriers and facilitators to quitting smoking. More tailored and targeted approaches to smoking cessation interventions for indigenous populations are required. The complexity of achieving smoking cessation is underscored as is the need to collaboratively develop interventions that are acceptable and appropriate to local populations. © 2011 by the authors; licensee MDPI, Basel, Switzerland.


Davidson P.M.,University of New South Wales | Davidson P.M.,St Vincents Hospital | Abbott P.,Aboriginal Medical Service Western Sydney | Abbott P.,University of Sydney | And 3 more authors.
Heart Lung and Circulation | Year: 2010

Background: Poor medication adherence is associated with adverse health outcomes. Improving access and adherence to pharmacological therapy is important in achieving optimal health outcomes for Indigenous populations. In spite of the impressive evidence base for cardiovascular pharmacotherapy, strategies for promoting adherence and evidence based practice are less well refined and the challenges for Indigenous populations are more pronounced. Aim: To identify factors impacting on medication adherence in Aboriginal Australians and identify solutions to improve the quality use of medicines. Method: The World Health Organization adherence model was used to classify barriers to adherence. Key elements of this model are (1) health care team/health system; (2) socio-economic factors; (3) therapy; (4) patient; and (5) condition related. Results: Entrenched socio-economic differentials aggravate challenges to medication adherence amongst Aboriginal Australians. Initiatives to promote the quality use of medicines, such as the Quality Use of Medicines Maximised for Aboriginal and Torres Strait Islander People (QUMAX) Program, are important strategies to promote adherence. Conclusions: Medication adherence is a complex issue and addressing modifiable factors is imperative to improve health outcomes. Subsidised access to medications whether living in urban, regional, rural or remote areas is an important strategy in Closing the Gap. © 2010.


Andersen M.J.,University of New South Wales | Andersen M.J.,Sax Institute | Williamson A.B.,University of New South Wales | Williamson A.B.,Sax Institute | And 3 more authors.
BMC Public Health | Year: 2016

Background: Poor housing is widely cited as an important determinant of the poor health status of Aboriginal Australians, as for indigenous peoples in other wealthy nations with histories of colonisation such as Canada, the United States of America and New Zealand. While the majority of Aboriginal Australians live in urban areas, most research into housing and its relationship with health has been conducted with those living in remote communities. This study explores the views of Aboriginal people living in Western Sydney about their housing circumstances and what relationships, if any, they perceive between housing and health. Methods: Four focus groups were conducted with clients and staff of an Aboriginal community-controlled health service in Western Sydney (n = 38). Inductive, thematic analysis was conducted using framework data management methods in NVivo10. Results: Five high-level themes were derived: the battle to access housing; secondary homelessness; overcrowding; poor dwelling conditions; and housing as a key determinant of health. Participants associated their challenging housing experiences with poor physical health and poor social and emotional wellbeing. Housing issues were said to affect people differently across the life course; participants expressed particular concern that poor housing was harming the health and developmental trajectories of many urban Aboriginal children. Conclusions: Housing was perceived as a pivotal determinant of health and wellbeing that either facilitates or hinders prospects for full and healthy lives. Many of the specific health concerns participants attributed to poor housing echo existing epidemiological research findings. These findings suggest that housing may be a key intervention point for improving the health of urban Aboriginal Australians. © 2016 Andersen et al.


Achat H.M.,Sydney West Area Health Service | Thomas P.,Aboriginal Medical Service Western Sydney | Close G.R.,Area Executive Unit | Moerkerken L.R.,Sydney West Area Health Service | Harris M.F.,University of New South Wales
Australian Journal of Primary Health | Year: 2010

This paper aimed to examine the utilisation of and preferences related to health care services by residents of a disadvantaged area and to identify factors associated with levels of current and future use. Data were collected from face-to-face structured interviews of randomly selected residents of a disadvantaged local government area in 200304. Information about respondents' health and socioeconomic status and patterns of use and preferred features of health care was analysed in PASW Statistic 17. Chi-square statistics were used to examine differences in utilisation by sex and simple logistic regression provided sex specific age-adjusted odds ratios about frequent visits. Most respondents (95%) attended a 'usual' general practitioner (GP) service and about two-fifths had obtained other health care in the last 12 months. The median number of visits was four and most providers offered bulk billing (83%). Less common were visits to the dentist (32%), emergency department (14%), specialists (29%) and the hospital (5%). Providers' skills and traits, physical access and bulk billing were key considerations for men and women when choosing a health care provider. Disadvantaged communities want skilled practitioners who reflect their demographic mix and are located at convenient and accessible clinics, which preferably bulk bill. Apart from GP visits, this group appears to make only moderate use of specialists and emergency departments, and little routine use of other primary health services. © La Trobe University 2010.


Abbott P.A.,Aboriginal Medical Service Western Sydney | Abbott P.A.,University of Sydney | Davison J.E.,Aboriginal Medical Service Western Sydney | Davison J.E.,University of Sydney | And 2 more authors.
Journal of Nutrition Education and Behavior | Year: 2012

Objectives: To examine the experiences of Aboriginal Australians with or at risk of diabetes who attended urban community cooking courses in 2002-2007; and to develop recommendations for increasing the uptake and effectiveness of nutrition education in Aboriginal communities. Methods: Descriptive qualitative approach using semistructured interviews with 23 Aboriginal course participants aged 19-72. Verbatim transcripts were coded using NVivo 7 software, and qualitative analysis was undertaken. Results: Engagement and learning were increased by emphasizing the social aspects of the program, holding the course in a familiar Aboriginal community-controlled health setting and using small group learning with Aboriginal peers. Partnership with a vocational training institute provided teaching expertise, but there was conflict between vocational and health promotion objectives. Conclusions and Implications: Nutrition programs for Aboriginal Australians should be social, flexible, and held in accessible, culturally appropriate settings and focus on healthful cooking techniques using simple, affordable ingredients. © 2012 Society for Nutrition Education and Behavior.


Abbott P.,Aboriginal Medical Service Western Sydney | Davison J.,Aboriginal Medical Service Western Sydney | Moore L.,Aboriginal Medical Service Western Sydney | Rubinstein R.,University of Sydney
Health Promotion Journal of Australia | Year: 2010

Issue addressed: Aboriginal people access diabetes and nutrition education less than non-Aboriginal people. Culturally appropriate, effective and accessible diabetes and nutrition education for Aboriginal people is urgently needed. Methods: A qualitative approach was used to explore the experiences of Aboriginal people who had attended cooking courses run at the Aboriginal Medical Service Western Sydney between 2002 and 2007. Data from 23 semi-structured interviews were analysed thematicaliy. Results: Despite reported improvements in nutrition knowledge and cooking skills, the ability of participants to implement desired dietary changes varied. A new health diagnosis, such as diabetes, pre-diabetes, heart disease or cancer and the desire of participants to influence their families to lead healthier, diabetes-free lives were strong motivators for dietary change. In contrast, lack of family support for dietary change and a sense of social isolation caused by dietary change strongly impeded some participants' attempts to improve their diets. Other significant barriers were poor oral health and depression, the higher cost of healthier food and generational food preferences. Conclusion: Aboriginal cooking course participants faced multiple barriers to dietary change - social, financial, medical and historical. The family was the most crucial determinant of participant ability to achieve sustained dietary change.


Abbott P.,Aboriginal Medical Service Western Sydney | Abbott P.,University of Western Sydney | Menzies R.,University of Sydney | Davison J.,Aboriginal Medical Service Western Sydney | And 2 more authors.
BMC Public Health | Year: 2013

Background: Delayed immunisation and vaccine preventable communicable disease remains a significant health issue in Aboriginal children. Strategies to increase immunisation coverage and timeliness can be resource intensive. In a low cost initiative at the Aboriginal Medical Service Western Sydney (AMSWS) in 2008-2009, a trial of personalised calendars to prompt timely childhood immunisation was undertaken. Methods. Calendars were generated during attendances for early childhood immunisations. They were designed for display in the home and included the due date of the next immunisation, a photo of the child and Aboriginal artwork. In a retrospective cohort design, Australian Childhood Immunisation Register data from AMSWS and non-AMSWS providers were used to determine the delay in immunisation and percentage of immunisations on time in those who received a calendar compared to those who did not. Interviews were undertaken with carers and staff. Results: Data on 2142 immunisation doses given to 505 children were analysed, utilising pre-intervention (2005-2007) and intervention (2008-2009) periods and a 2 year post-intervention observation period. 113 calendars were distributed (30% of eligible immunisation attendances). Improvements in timeliness were seen at each schedule point for those children who received a calendar. The average delay in those who received a calendar at their previous visit was 0.6 months (95% CI -0.8 to 2.6) after the due date, compared to 3.3 months (95% CI -0.6 to 7.5) in those who did not. 80% of doses were on time in the group who received a calendar at the preceding immunisation, 66% were on time for those who received a calendar at an earlier point and 57% of doses were on time for those who did not receive a calendar (P<0.0001, Cochran-Armitage trend test). Interview data further supported the value and effectiveness of the calendars as both a prompt to timely immunisations and a community health education project without undue resource implications. Conclusions: Personalised calendars can increase the timeliness of immunisations in Aboriginal children. This simple, low cost tool appears practicable and effective in an Aboriginal community setting in improving early childhood vaccination timeliness and has high potential for local adaptation to suit the needs of diverse communities. © 2013 Abbott et al.; licensee BioMed Central Ltd.

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