The Development of a Survey Instrument to Assess Aboriginal and Torres Strait Islander Students’ Resilience and Risk for Self-Harm

Abstract

Background: Australian policies for Aboriginal and Torres Strait Islander well-being outline the importance of local community-based interventions; for adolescents, schoolbased programs have been identified as beneficial. However, there is a lack of localized data to determine levels of resilience and risk and thus whether programs are effective. This paper describes the challenges and opportunities in collaboratively designing and piloting a localized survey instrument to measure Indigenous students' resilience and upstream risk factors for self-harm and the resultant instrument.Methods: A participatory action research approach was used to engage education staff, health-care providers, students, and researchers to design and pilot the survey instrument. A six-phased process facilitated survey development: (1) defining the logic and exploring the evidence; (2) understanding and tailoring for context; (3) testing for feasibility and relevance; (4) testing for appropriateness and comprehension; (5) facilitating survey administration; and (6) refining the instrument. Processes in each phase were recorded and transcribed with thematic analysis used to identify key challenges and opportunities arising during development.results: Four key challenges and opportunities were identified: (1) the relevance of international survey instruments for Indigenous Australian students; (2) accounting for distinct environments; (3) the balance between assessing risk and protective factors; and (4) tailoring for literacy levels and school engagement. The final Student Survey instrument comprised 4 demographic and 56 resilience, risk, service use, and satisfaction questions. The T4S will be administered routinely on annual student intake. Discussion and conclusion: The six-phased participatory processes resulted in a tailored instrument that could identify the critical resilience and upstream risk factors facing a cohort of Indigenous students who attend boarding schools for secondary education. Challenges were resolved collaboratively and the pilot results were directly translated to education practice and its integration with health services. Our results suggest that both the phased process of developing the T4S and the instrument itself can be adapted for other Indigenous adolescent well-being and/or self-harm prevention programs.

Validation and Factor Analysis of the Child and Youth Resilience Measure for Indigenous Australian Boarding School Students

“…Consistent with recommendations to ensure cultural and contextual relevance ( 32 ), the CYRM-28 was cross-culturally adapted for use in our study with Indigenous Australian boarding school students (years 7–12). A six phase participatory action research process was used that resulted in: tailoring the CYRM-28 for the contexts of the distinct environments of boarding school and remote communities; adding 11 site-specific items; addressing relevant wellbeing issues; and delivering it in ways that are appropriate to the literacy levels and age of the students [this phase of the project is detailed at ( 13 )]. That process established both content and face validity for the resultant T4S instrument which incorporates the CYRM-28 ( 13 ).…”

“…There are a range of survey instruments available internationally to measure resilience for both the general population and youth ( 9 – 11 ). However, they are rarely or inconsistently used to inform decision-making in health and education services for Indigenous youth ( 12 ) for reasons that include: concerns about risk based questions and their potential impact on students; lack of resourcing for services to conduct intervention-based research; concerns over the capacity to respond to mental health issues raised by the instrument, and; concerns over the appropriateness and relevance of international instruments for utility with Indigenous Australian youth ( 13 ). The suitability of international instruments for use with Indigenous Australian youth is also linked to broader concerns of data sovereignty—the production, ownership, and use of Indigenous data—and the cultural appropriateness of using standard measures in Indigenous contexts ( 14 , 15 ).…”

Integrating Healthcare Services for Indigenous Australian Students at Boarding Schools: A Mixed-Methods Sequential Explanatory Study

“…An amended Transition Support Service Student Survey (T4S) instrument [24] was utilised. Amendments included use of the Kessler 6 instead of the Kessler 5 and a reduced Demographics: Participants' age, gender, and home community were included.…”

“…This study focuses on the health, healthcare service use and satisfaction of a cohort of Indigenous remote-dwelling north Queensland students who are required to attend boarding schools for secondary education because there is limited or no secondary schooling available in their home communities. It forms part of a broader ecological study to support and enhance the resilience of these students; other papers have provided a study protocol [22], descriptions of the survey development and validation [23,24], description of staff capacity development [25] and student survey baseline results [26]. Anecdotal evidence (2016) attained through this broader resilience study suggested that some students had untreated health conditions upon arrival at or during boarding school education, and/or experienced patchy care between remote home community and schoolbased healthcare services.…”

Enhancing Social and Emotional Wellbeing of Aboriginal Boarding Students: Evaluation of a Social and Emotional Learning Pilot Program

“…Here, social and emotional learning (SEL) programs provide a promising pathway. SEL programs have been effective in increasing resilience to adversity, improving mental health and reducing suicidal ideation [7,[15][16][17]. Research also indicates that SEL programs enhance social competence and academic success [18,19].…”