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The high rate (50%) of smoking among Aboriginal people (ABS 2005) coupled with limited culturally appropriate smoking cessation interventions makes addressing this important public health issue a challenge. The Aboriginal [...]

Cardiovascular disease (CVD) is the leading cause of death in the Australian Indigenous population (ABS and AIHW 2001). Unfortunately, Australian Aboriginals have not benefited from the reductions In CVD seen [...]

Aboriginal people access diabetes and nutrition education less than non-Aboriginal people. Culturally appropriate, effective and accessible diabetes and nutrition education for Aboriginal people is urgently needed. A qualitative approach was used to explore the experiences of Aboriginal people who had attended cooking courses run at the Aboriginal Medical Service Western Sydney between 2002 and 2007. Data from 23 semi-structured interviews were analysed thematically. Despite reported improvements in nutrition knowledge and cooking skills, the ability of participants to implement desired dietary changes varied. A new health diagnosis, such as diabetes, pre-diabetes, heart disease or cancer and the desire of participants to influence their families to lead healthier, diabetes-free lives were strong motivators for dietary change. In contrast, lack of family support for dietary change and a sense of social isolation caused by dietary change strongly impeded some participants' attempts to improve their diets. Other significant barriers were poor oral health and depression, the higher cost of healthier food and generational food preferences. Aboriginal cooking course participants faced multiple barriers to dietary change – social, financial, medical and historical. The family was the most crucial determinant of participant ability to achieve sustained dietary change. Recognition of these barriers must inform the design and delivery of nutrition interventions in Aboriginal communities. In particular, nutrition interventions should target the family unit and incorporate strategies for combating possible negative social effects of dietary change in order to maximise their effectiveness.

A partnership model was established among key education providers, policy makers, non-government organisations, the local area health service and Aboriginal community controlled organisations aimed at increasing collaboration, skill development, cultural competence and increasing access to mentorship and expertise for Aboriginal Health Workers (AHWs). A group of 21 AHWs, within two cohorts, undertook the program between October 2005 and June 2006. A mixed-method evaluation using quantitative and qualitative data collection methods was undertaken prospectively. Knowledge and confidence scores significantly increased for all participants over the course duration. Student evaluation demonstrated a desire for groupbased activities and the high value placed on clinical visits. Feedback on both outcome and process measures will inform course delivery and design.

Purpose:To determine prevalence and patterns of use of complementary and alternative medicine (CAM) among men recently diagnosed with prostate cancer.Study Design:Men, diagnosed with prostate cancer over a 10-month period in British Columbia, Canada, were randomly selected to obtain a population-based sample.Methods:Surveys, addressing patient demographics, types of CAM therapies, and CAM information resources utilized, reasons for use, and disclosure to physician(s), were mailed to 1108 men newly diagnosed with prostate cancer. A 42% response rate was obtained.Results:Thirty-nine percent of patients used CAM therapies with the most common being herbal supplements (saw palmetto), vitamins (vitamin E), and minerals (selenium). The most common reasons given for choosing to use CAM therapies were to (1) boost the immune system and (2) prevent recurrence. The majority of men (58%) had told their physician(s) about their CAM use, but few utilized either their family physician (15%) or their oncologist (7%) as sources of CAM information. CAM users most commonly consulted friends or family (39%) or the Internet (19%) for information about CAM. CAM users were more likely than nonusers to delay (9%) or decline (4%) conventional treatment. Respondents who had never used CAM had typically never thought about it or did not have enough information about the treatments.Conclusions:More than one third of recently diagnosed prostate cancer patients utilize some form of CAM therapy, and the majority disclose their use to their physician(s). However, they tend to rely on anecdotal information for their CAM decision making. Dissemination of reliable CAM information is one key to helping men navigate this difficult arena.

Objective: Aboriginal and Torres Strait Islander people experience adverse health outcomes and have high rates of smoking and related illnesses. This brief report describes stress as a barrier to quitting smoking derived from reflections within an Aboriginal Medical Service and makes recommendations for intervention development. Methods: A high‐intensity smoking cessation program was conducted within a suburban Aboriginal Medical Service in Western Sydney, Australia, over a 10‐month period. The intervention included weekly cessation counselling sessions and dispensation of free nicotine replacement therapy (NRT). Results: During the observation period, 32 clients made quit attempts. To date, three clients (9%) have quit smoking. Chronic and intercurrent life stressors were noted to be the main barriers to smoking cessation described by participants. Conclusions: Achieving smoking cessation among Indigenous people is made significantly more complex because of multiple life stressors experienced. Implications: Future interventions targeting Indigenous Australians should take greater account of stressful life events and their impact on quitting smoking.