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Objectives.Cancer is the second biggest killer of Aboriginal Australians. For some cancers, the mortality rate is more than three times higher in Aboriginal people than for non-Aboriginal people. The Aboriginal Patterns of Cancer Care Study explored barriers to and facilitators of cancer diagnosis and treatment among Aboriginal and Torres Strait Islander people in New South Wales. Design.Our team – which includes both Aboriginal and non-Aboriginal researchers – conducted in-depth interviews between 2009 and 2010 with Aboriginal people with cancer, their carers and health professionals who care for them. In this paper, we identify recurrent patterns of ‘discursive framing’ in the 16 interviews with health care professionals. We are particularly interested in how these frames assisted participants in constructing a professional position on what ‘cultural difference’ means for the design and delivery of cancer care services to Aboriginal people. Results.Despite geographical, organisational, disciplinary and cultural diversity, these interview participants consistently drew upon six discursive frames, which we have interpreted as eitherelidinga discussion ofdifference(‘everyone is the same’ and ‘everyone is different’) orfacilitatingthat discussion (‘different priorities,’ ‘different practices’ and ‘making difference safe’). An additional strategy appeared to actively resist either of these positions but then tended to ultimately prioritise the eliding frames. Conclusions.While none of our participants were dismissive of the idea that cultural identity might matter to Aboriginal people, their reliance upon familiar narratives about what that means for cancer care services has the potential to both symbolically and practically exclude the voices of a group of people who may already feel disenfranchised from the mainstream health care system. Critically unpacking the ‘taken for granted’ assumptions behind how health care professionals make sense of cultural difference can enrich our understanding of and response to the care needs of indigenous people affected by cancer. [ABSTRACT FROM PUBLISHER]

Objectives: Though several studies have focused on risk factors associated with excess weight gain, little is known about the extent to which socio-cultural beliefs about body sizes may contribute to risk of excess weight gain, especially in non-Western migrant communities. Drawing on socio-cultural and attribution theories, this study mainly explored socio-cultural beliefs about an ideal body size among Australian residents who were born in sub-Saharan Africa (SSA). Implications of body size beliefs for risk of excess weight gain after immigration have also been discussed. Design: Employing a qualitative design, 24 in-depth interviews were conducted with Australian residents who were born in SSA. Thematic content analysis was undertaken to ensure that participants' experiences and views were clearly captured. Results: According to the participants, a moderately large body size is idealised in the SSA community and post-migration weight gain is commonly regarded as evidence of well-being. While desirability of a moderately large body size was noted by some participants, others were concerned about health risks (e.g. high blood pressure) associated with excess weight gain. Moreover, body size ideals seemed to be different for men and women in the SSA community and these ideals were mainly promoted by family and friends. Participants reported that women with very slim (skinny) body sizes are often regarded as persons suffering from health problems, whereas those with 'plumpy' body types are often considered beautiful. Participants also noted that men are expected to look well-built and muscular while those with big bellies are often seen as financially rich. Conclusions: Participants' interpretation of post-migration weight gain as evidence of well-being calls for urgent intervention as risk of excess weight gain appear to be high in this immigrant group. [ABSTRACT FROM AUTHOR]

Objective: To explore anti-diabetic medication taking behaviour in Nepalese patients with type 2 diabetes and investigate the factors impacting medication taking in this population. Design: Face-to-face interviews (n = 48) were conducted with Nepalese patients with type 2 diabetes in Sydney (Australia) and Kathmandu (Nepal). All interviews were audio-recorded, transcribed verbatim and thematically analysed. Participants’ medication adherence was also assessed quantitatively using the summary of diabetes self-care activity (SDSCA) questionnaire. Results: The medication taking behaviour of Nepalese participants aligned with the Stages of Change Model, with some notable patterns of behaviour. Most participants initiated and implemented anti-diabetic medications soon after obtaining their prescription. However, a few, delayed initiation and/or ceased medications after initiation to recommence later. Nonetheless, upon recommencement, participants persisted fairly well with their medications. The self-reported medication adherence was high (97.3%). Although some participants expressed adherence as a challenge at the start of therapy, medication taking on a day-to-day basis was not reported as difficult. Factors such as participants’ reluctance towards using medications and preference for natural methods of treatment, together with inadequate understanding about diabetes and treatment resulted in the delay in initiating therapy, and contributed to cessation of therapy. On the other hand, ooccasional non-adherence in daily medication taking was mostly related to inconsistency in meal practices and forgetfulness. Encouragement from doctors and increased awareness about the disease and treatment facilitated medication adherence, including initiation of therapy. Conclusion: This study demonstrates that Nepalese patients are likely to delay or cease anti-diabetic medications until they fully accept and acknowledge the benefits and necessity of medications for effective diabetes management. Thus, educating patients about the need for medications, as well as implementing strategies to address patients’ psychological resistance towards medications will be essential for effective medication management. [ABSTRACT FROM AUTHOR]

Introduction. Despite Aboriginal Australians being over-represented in populations of people living with hepatitis C (HCV), there is a dearth of research to guide policy and programme development in the area of care and treatment, particularly relating to new HCV treatments. Method. In-depth interviews were conducted with 39 people identifying as Aboriginal Australians and living with HCV in New South Wales. Results. Participants' experiences were characterised by a lack of detailed or appropriate information provided at diagnosis, high levels of stigma associated with HCV and low overall knowledge of HCV as reported for themselves and their communities. Despite poor diagnosis experiences, participants had undertaken changes to their lifestyle, especially in relation to alcohol use, in order to promote liver health. Concerns about treatment side effects and efficacy impacted participants' decisions to undertake treatment. Eleven participants had undertaken HCV treatment in a variety of care models with a peer worker and in prison. Conclusions. The similarities between concerns and experiences of Aboriginal people and other populations living with HCV do not suggest that services and strategies to engage these populations should also be the same. These results suggest that further engagement of the primary care sector in HCV care is important as well as increasing Aboriginal community knowledge of HCV. A variety of service models should be available to meet individuals' preferences, including those offered within Aboriginal community controlled health services emphasising holistic notions of health, and supported by information and communication programmes using principles of health literacy relevant to Aboriginal people. [ABSTRACT FROM AUTHOR]