Measures of the gap in living standards, life expectancy, education, health and employment between Indigenous and non-Indigenous Australians are primarily derived from administrative data sources. However, Indigenous identification in these data sources is affected by administrative practices, missing data, inconsistency, and error. As these factors have changed over time, assessing whether the gap between Indigenous and non-Indigenous Australians has changed over time, based on data unadjusted for these sources of error can potentially lead to misguided conclusions. Combining administrative data on the same individuals collected from different sources provides a method by which a more consistent derived Indigenous status can be applied across all records for an individual within a linked data environment. We used the Western Australian Data Linkage system to produce derived Indigenous statuses for individuals using a range of algorithms. We found that these algorithms reduced the amount of missing data and improved within-individual consistency. Based on these findings, we recommend our Multi-Stage Median algorithm be used as the standard indicator of Indigenous status for any reporting based on administrative datasets when multiple datasets are available for linkage, and that algorithmic approaches also be considered for improving the quality of other demographic variables from administrative data sources.

BackgroundHealth promotion organizations are increasingly embracing social media technologies to engage end users in a more interactive way and to widely disseminate their messages with the aim of improving health outcomes. However, such technologies are still in their early stages of development and, thus, evidence of their efficacy is limited.ObjectiveThe study aimed to provide a current overview of the evidence surrounding consumer-use social media and mobile software apps for health promotion interventions, with a particular focus on the Australian context and on health promotion targeted toward an Indigenous audience. Specifically, our research questions were: (1) What is the peer-reviewed evidence of benefit for social media and mobile technologies used in health promotion, intervention, self-management, and health service delivery, with regard to smoking cessation, sexual health, and otitis media? and (2) What social media and mobile software have been used in Indigenous-focused health promotion interventions in Australia with respect to smoking cessation, sexual health, or otitis media, and what is the evidence of their effectiveness and benefit?MethodsWe conducted a scoping study of peer-reviewed evidence for the effectiveness of social media and mobile technologies in health promotion (globally) with respect to smoking cessation, sexual health, and otitis media. A scoping review was also conducted for Australian uses of social media to reach Indigenous Australians and mobile apps produced by Australian health bodies, again with respect to these three areas.ResultsThe review identified 17 intervention studies and seven systematic reviews that met inclusion criteria, which showed limited evidence of benefit from these interventions. We also found five Australian projects with significant social media health components targeting the Indigenous Australian population for health promotion purposes, and four mobile software apps that met inclusion criteria. No evidence of benefit was found for these projects.ConclusionsAlthough social media technologies have the unique capacity to reach Indigenous Australians as well as other underserved populations because of their wide and instant disseminability, evidence of their capacity to do so is limited. Current interventions are neither evidence-based nor widely adopted. Health promotion organizations need to gain a more thorough understanding of their technologies, who engages with them, why they engage with them, and how, in order to be able to create successful social media projects.

BackgroundImproving oral health for Aboriginal Australians has been slow. Despite dental disease being largely preventable, Aboriginal Australians have worse periodontal disease, more decayed teeth and untreated dental caries than other Australians. Reasons for this are complex and risk factors include broader social and historic determinants such as marginalisation and discrimination that impact on Aboriginal people making optimum choices about oral health. This paper presents findings from a qualitative study conducted in the Perth metropolitan area investigating Aboriginal Health Workers’ (AHWs) perceptions of barriers and enablers to oral health for Aboriginal people.MethodsFollowing extensive consultation with Aboriginal stakeholders, researchers conducted semi-structured interviews and focus groups across 13 sites to investigate AHWs’ perceptions of barriers and enablers to oral health based on professional and personal experience. Responses from 35 AHWs were analysed independently by two researchers to identify themes that they compared, discussed, revised and organised under key themes. These were summarised and interrogated for similarities and differences with evidence in the literature.ResultsKey findings indicated that broader structural and social factors informed oral health choices. Perceptions of barriers included cost of services and healthy diets on limited budgets, attending services for pain not prevention, insufficient education about oral health and preventing disease, public dental services not meeting demand, and blame and discrimination from some health providers. Suggested improvements included oral health education, delivering flexible services respectful of Aboriginal people, oral health services for 0–4 year olds and role modelling of oral health across generations.ConclusionReviewing current models of oral health education and service delivery is needed to reduce oral health disparities between Aboriginal and non-Aboriginal Australians. Shifting the discourse from blaming Aboriginal people for their poor oral health to addressing structural factors impacting on optimum oral health choices is important. This includes Aboriginal and non-Aboriginal stakeholders working together to develop and implement policies and practices that are respectful, well-resourced and improve oral health outcomes.

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OBJECTIVE To determine whether disparities in the nature and management of type 2 diabetes persist between Aboriginal and the majority Anglo-Celt patients in an urban Australian community. RESEARCH DESIGN AND METHODS Baseline data from the observational Fremantle Diabetes Study collected from 1993 to 1996 (phase I) and from 2008 to 2011 (phase II) were analyzed. Patients characterized as Aboriginal or Anglo-Celt by self-report and supporting data underwent comprehensive assessment, including questionnaires, examination, and biochemical testing in a single laboratory. Generalized linear modeling with age/sex adjustment was used to examine differences in changes in variables in the two groups between phases I and II. RESULTS The indigenous participants were younger at entry and at diabetes diagnosis than the Anglo-Celt participants in both phases. They were also less likely to be educated beyond primary level and were more likely to be smokers. HbA 1c decreased in both groups over time (Aboriginal median 9.6% [interquartile range 7.8–10.7%] to 8.4% [6.6–10.6%] vs. Anglo-Celt median 7.1% [6.2–8.4%] to 6.7% [6.2–7.5%]), but the gap persisted ( P = 0.65 for difference between phases I and II by ethnic group). Aboriginal patients were more likely to have microvascular disease in both phases. The prevalence of peripheral arterial disease (ankle-brachial index ≤0.90 or lower-extremity amputation) increased in Aboriginal but decreased in Anglo-Celt participants (15.8–29.7 vs. 30.7–21.5%; P = 0.055). CONCLUSIONS Diabetes management has improved for Aboriginal and Anglo-Celt Australian patients, but disparities in cardiovascular risk factors and complications persist.