The risk status, screening history and health concerns of Aboriginal and Torres Strait Islander people attending an Aboriginal Community Controlled Health Service

Stewart, Jessica; Sanson‐Fisher, Rob; Eades, Sandra; Fitzgerald, Michael L.

doi:10.1111/j.1465-3362.2012.00455.x

Cited by 14 publications

(17 citation statements)

References 16 publications

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“…Women in Far North Queensland also experience additional challenges, including long distances to travel to receive an OGTT, real or perceived costs associated with tests from limited private laboratory services, high staff turnover, and high population mobility. Another challenge is the number of guidelines which address cardio-metabolic risk screening among Indigenous people, who may fall under several 'risk' categories [67][68][69][70][71][72]. Most guidelines recommend regular glucose screening, however only gestational diabetes guidelines advise an OGTT be used as a screening test, rather than a diagnostic test; as both FPG and HbA1C have lower sensitivity and may not detect impaired glucose tolerance [73][74][75].…”

Section: Discussionmentioning

confidence: 99%

Low Rates of Postpartum Glucose Screening Among Indigenous and non-Indigenous Women in Australia with Gestational Diabetes

Chamberlain

McLean

Oats

et al. 2014

Matern Child Health J

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Women with gestational diabetes have a high risk of type 2 diabetes postpartum, with Indigenous women particularly affected. This study reports postpartum diabetes screening rates among Indigenous and non-Indigenous women with gestational diabetes, in Far North Queensland, Australia. Retrospective study including 1,012 women with gestational diabetes giving birth at a regional hospital from 1/1/2004 to 31/12/2010. Data were linked between hospital records, midwives perinatal data, and laboratory results, then analysed using survival analysis and logistic regression. Indigenous women had significantly longer times to first oral glucose tolerance test (OGTT) [hazards ratio (HR) 0.62, 95 % confidence interval (CI) 0.48-0.79, p < 0.0001) and 'any' postpartum glucose test (HR 0.81, 95 % CI 0.67-0.98, p = 0.03], compared to non-Indigenous women. Postpartum screening rates among all women were low. However, early OGTT screening rates (<6 months) were significantly lower among Indigenous women (13.6 vs. 28.3 %, p < 0.0001), leading to a persistent gap in cumulative postpartum screening rates. By 3 years postpartum, cumulative rates of receiving an OGTT, were 24.6 % (95 % CI 19.9-30.2 %) and 34.1 % (95 % CI 30.6-38.0 %) among Indigenous and non-Indigenous women, respectively. Excluding OGTTs in previous periods, few women received OGTTs at 6-24 months (7.8 vs. 6.7 %) or 2-4 years (5.2 vs. 6.5 %), among Indigenous and non-Indigenous women, respectively. Low rates of postpartum diabetes screening demonstrate that essential 'ongoing management' and 'equity' criteria for population-based screening for gestational diabetes are not being met; particularly among Indigenous women, for whom recent guideline changes have specific implications. Strategies to improve postpartum screening after gestational diabetes are urgently needed.

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Section: Discussionmentioning

confidence: 99%

Low Rates of Postpartum Glucose Screening Among Indigenous and non-Indigenous Women in Australia with Gestational Diabetes

Chamberlain

McLean

Oats

et al. 2014

Matern Child Health J

Self Cite

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“…For example, many Aboriginal health workers are themselves smokers, and may feel uncomfortable assessing the smoking status of their patients and providing cessation advice [19,20]. The need to prioritise across a complex array of health and other problems facing many Aboriginal patients is a further challenge to achieving regular assessment of modifiable health risks and the provision of preventive health care [14,21]. …”

Section: Introductionmentioning

confidence: 99%

A cross-sectional survey assessing the acceptability and feasibility of self-report electronic data collection about health risks from patients attending an Aboriginal Community Controlled Health Service

Noble

Paul

Carey

et al. 2014

BMC Med Inform Decis Mak

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BackgroundAboriginal Australians experience significantly worse health and a higher burden of chronic disease than non-Aboriginal Australians. Electronic self-report data collection is a systematic means of collecting data about health risk factors which could help to overcome screening barriers and assist in the provision of preventive health care. Yet this approach has not been tested in an Aboriginal health care setting. Therefore, the aim of this study was to examine the acceptability and feasibility of a health risk questionnaire administered on a touch screen laptop computer for patients attending an Aboriginal Community Controlled Health Service (ACCHS).MethodsIn 2012, consecutive adult patients attending an ACCHS in rural New South Wales, Australia, were asked to complete a health risk survey on a touch screen computer. Health risk factors assessed in the questionnaire included smoking status, body mass index, and level of physical activity. The questionnaire included visual cues to improve accuracy and minimise literacy barriers and was completed while participants were waiting for their appointment.ResultsA total of 188 participants completed the questionnaire, with a consent rate of 71%. The mean time taken to complete the questionnaire was less than 12 minutes. Over 90% of participants agreed that: the questionnaire instructions were easy to follow; the touch screen computer was easy to use; they had enough privacy; the questions were easy to understand; they felt comfortable answering all the questions.ConclusionsResults indicate that the use of a touch screen questionnaire to collect information from patients about health risk factors affecting Aboriginal Australians is feasible and acceptable in the ACCHS setting. This approach has potential to improve identification and management of at-risk individuals, therein providing significant opportunities to reduce the burden of disease among Aboriginal Australians.

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“…The average BMI is < 20, and fasting blood glucose, cholesterol, and blood pressure are all low [35]. In contrast, Westernized Aboriginal groups are three times as likely to develop diabetes than non-indigenous Australians upon transitioning to the Australian diet [36], [37]. When Westernized diabetic Aborigines reverted temporarily to their traditional diet and lifestyle, there was an observed reduction in the metabolic abnormalities associated with diabetes [35].…”

Section: Evolution Of the Western Diet And Microbial Selectionmentioning

confidence: 99%

The changing microbial landscape of Western society: Diet, dwellings and discordance

Broussard

Devkota

2016

Molecular Metabolism

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BackgroundThe last 50–100 years has been marked by a sharp rise in so-called “Western-diseases” in those countries that have experienced major industrial advances and shifts towards urbanized living. These diseases include obesity, type 2 diabetes, inflammatory bowel diseases, and food allergies in which chronic dysregulation of metabolic and/or immune processes appear to be involved, and are likely a byproduct of new environmental influences on our ancient genome. What we now appreciate is that this genome consists of both human and co-evolved microbial genes of the trillions of microbes residing in our body. Together, host–microbe interactions may be determined by the changing diets and behaviors of the Western lifestyle, influencing the etiopathogenesis of “new-age” diseases.Scope of reviewThis review takes an anthropological approach to the potential interplay of the host and its gut microbiome in the post-industrialization rise in chronic inflammatory and metabolic diseases. The discussion highlights both the changes in diet and the physical environment that have co-occurred with these diseases and the latest evidence demonstrating the role of host–microbe interactions in understanding biological responses to the changing environment.Major conclusionsTechnological advances that have led to changes in agriculture and engineering have altered our eating and living behaviors in ways never before possible in human history. These changes also have altered the bacterial communities within the human body in ways that are seemingly linked with the rise of many intestinal and systemic metabolic and inflammatory diseases. Insights into the mechanisms of this reciprocal exchange between the environment and the human gut microbiome may offer potential to attenuate the chronic health conditions that derail quality of life. This article is part of a special issue on microbiota.

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The risk status, screening history and health concerns of Aboriginal and Torres Strait Islander people attending an Aboriginal Community Controlled Health Service

Abstract: Introduction and Aims. Primary health-care services need to maximise prevention activities to improve the health of

Cited by 14 publications

References 16 publications

Low Rates of Postpartum Glucose Screening Among Indigenous and non-Indigenous Women in Australia with Gestational Diabetes

Low Rates of Postpartum Glucose Screening Among Indigenous and non-Indigenous Women in Australia with Gestational Diabetes

A cross-sectional survey assessing the acceptability and feasibility of self-report electronic data collection about health risks from patients attending an Aboriginal Community Controlled Health Service

The changing microbial landscape of Western society: Diet, dwellings and discordance

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