Objective: To describe a process of meaningful Aboriginal community engagement that repositioned and valued community members’ knowledge(s) and lived experiences while strengthening relationships, research processes and outcomes. Background: Aboriginal Australians have the oldest continuous culture in the world, yet due to effects of colonisation, experience some of the world's poorest health outcomes. The AKction [Aboriginal Kidney Care Together – Improving Outcomes Now] project brought together Aboriginal people with lived experience of kidney disease, clinicians and researchers to improve kidney care. Methodology: Using Aboriginal methodologies of Ganma and Dadirri within community‐based participatory action research (cb‐PAR), a core advisory group of Aboriginal people with lived experiences of kidney disease worked closely with clinicians and researchers. Results: Three community consultation workshops that deeply valued Aboriginal knowledge(s) were co‐created. Community members formed a reference group, established partnerships and influenced health research, policy and service provision. Non‐Indigenous researchers engaged in critical self‐reflection and levelling of Western‐Aboriginal and clinician‐consumer power imbalances. Conclusions: Deeply respectful community engagement is possible through co‐creation and cb‐PAR. It results in multiple positive impacts and beneficial relationships between community members, clinicians and academics. Implications for public health: Meaningful consultation with Aboriginal communities guides culturally safe research processes, health policy and service delivery.
Objective: To describe the experiences, perceptions and suggested improvements in healthcare identified by Aboriginal patients, families and community members living with kidney disease in South Australia. Methods: Community consultations were held in an urban, rural and remote location in 2019 by the Aboriginal Kidney Care Together – Improving Outcomes Now (AKction) project and Kidney Health Australia. Consultations were co‐designed with community members, using participatory action research, Yarning, Dadirri and Ganma Indigenous Methodologies. Key themes were synthesised, verified by community members and shared through formal and community reports and media. Results: Aboriginal participants identified the importance of: family and community and maintaining their wellbeing, strength and resilience; the need for prevention and early detection that is localised, engages whole families and prevents diagnosis shock; better access to quality care that ensures Aboriginal people can make informed choices and decisions about their options for dialysis and transplantation, and; more Aboriginal health professionals and peer navigators, and increased responsiveness and provision of cultural safety care by all kidney health professionals. Conclusion: Aboriginal community members have strong and clear recommendations for improving the quality and responsiveness of health care generally, and kidney care specifically. Implications for public health: Aboriginal people with lived experience of chronic conditions wish to significantly inform the way care is organised and delivered.
Online platforms have emerged as a convenient way for individuals to access contraception. However, the extent to which such services exist in Australia and how they operate is currently unknown. We aimed to identify Australian online contraception platforms and evaluate the services they provide to determine the degree to which they may facilitate equitable access to contraception. We conducted an internet search to identify online contraception platforms operating in Australia. Data were extracted from each of the platforms relating to operating policies, services provided and associated payment processes, as well as prescribing and screening processes for assessing user suitability. As of July 2022, eight online contraception platforms operating within Australia were identified. All platforms offered oral contraception, with two also offering the vaginal ring, and one emergency oral contraception. None of the platforms provided access to long-acting reversible contraception. Significant variability existed in product and membership costs across platforms, with only one platform providing access to subsidised medicines. Five platforms restricted services to those already using oral contraception. Overall, online questionnaires were deemed to be adequately screening for important contraindications to using oral contraception. While online contraception platforms may be a valuable option for some individuals who face access barriers and are willing to pay out-of-pocket for to have their contraception sent straight to their home, they do not necessarily ensure that individuals can access their contraceptive method of choice or address recognised financial and structural barriers to contraceptive care.
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