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BackgroundFacebook is widely used by Australia’s First Nations people and has significant potential to promote health. However, evidence-based guidelines for its use in health promotion are lacking. Smoking prevalence among Australia’s First Nations people is nearly 3 times higher than other Australians. Locally designed programs in Aboriginal Community Controlled Health Services (ACCHOs) to reduce smoking often use Facebook. ObjectiveThis study reports on an analysis of the reach and engagement of Facebook posts with smoking prevention and cessation messages posted by ACCHOs in the Northern Territory, Australia. MethodsEach service posted tobacco control content at least weekly for approximately 6 months. Posts were coded for the following variables: service posted, tailored First Nations Australian content, local or nonlocally produced content, video or nonvideo, communication technique, and emotional appeal. The overall reach, shares, and reactions were calculated. ResultsCompared with posts developed by the health services, posts with content created by other sources had greater reach (adjusted incident rate ratio [IRR] 1.92, 95% CI 1.03-3.59). Similarly, reactions to posts (IRR 1.89, 95% CI 1.40-2.56) and shared posts (IRR 2.17, 95% CI 1.31-3.61) with content created by other sources also had more reactions, after controlling for reach, as did posts with local First Nations content compared with posts with no First Nations content (IRR 1.71, 95% CI 1.21-2.34). ConclusionsFacebook posts with nonlocally produced content can be an important component of a social media campaign run by local health organizations. With the exception of nonlocally produced content, we did not find a definitive set of characteristics that were clearly associated with reach, shares, and reactions. Beyond reach, shares, and likes, further research is needed to understand the extent that social media content can influence health behavior.

: Objectives: To explore the acceptability of a novel, outreached‐based approach to improve primary and primordial prevention of Strep A skin sores, sore throats and acute rheumatic fever in remote Aboriginal communities. Methods: A comprehensive prevention program delivered by trained Aboriginal Community Workers was evaluated using approximately fortnightly household surveys about health and housing and clinical records. Results: Twenty‐seven primary participants from three remote Aboriginal communities in the Northern Territory consented, providing 37.8 years of retrospective baseline data and 18.5 years of prospective data during the study period. Household members were considered to be secondary participants. Five Aboriginal Community Workers were trained and employed, delivering a range of supports to households affected by acute rheumatic fever including environmental health support and education. Clinical record audit and household self‐report of Strep A infections were compared. No association between clinical‐ and self‐report was identified. Conclusions: Ongoing participation suggests this outreach‐based prevention program was acceptable and associated with improved reporting of household maintenance issues and awareness of prevention opportunities for Strep A infections. Implications for public health: Biomedical, clinic‐based approaches to the management of Strep A infections in remote communities can be usefully augmented by outreach‐based supports delivered by Aboriginal Community Workers responding to community needs., Rheumatic heart disease (RHD) is the leading cause of cardiovascular inequality between Aboriginal and Torres Strait Islander people and non‐Indigenous people in Australia.[sup.1] RHD stems from group A streptococcal (Strep [...]

Mainstream media in countries like Australia often perpetuate dominant narratives rooted in settler-coloniser culture, legitimising existing power dynamics and reinforcing inequities. However, in recent decades as the media landscape has fragmented, control over the dominant narrative has loosened and independent podcasters have emerged as powerful agents of narrative change. Narrative change is an emerging field of action research that has grown from social justice activists who believe that personal stories have the power to shift hearts, heads and eventually policies that maintain inequities. However narrative change as a concept is undefined in peer-reviewed literature. Drawing inspiration from Critical Race Theory and Freirean pedagogy, this paper argues key tenets from these two decolonising theories to be considered foundational to narrative change. By examining the utilisation of ‘counterstories’ and ‘problem-posing education’, the paper aims to provide insights into how podcasters can effectively foster intimacy between First Nations peoples and White Australians and change the narrative settler colonisers have perpetuated. To explore these concepts a podcast titled Ask the Specialist: Larrakia, Tiwi and Yolŋu stories to inspire better healthcare will be presented as a case study. [ABSTRACT FROM AUTHOR]

Addressing the question "how is a podcast created?" – four podcasters document their practice as research, framing their experiences as a research enquiry while making their first podcast. Practitioner Based Enquiry was the methodology and reflective practice was one of the methods underpinning the stages of podcasting production. These accounts of practice, and the reflective deliberations, are critically examined using Gidden's Structuration and Bourdieu's Cultural Production theories to reveal how these actions are creatively and collaboratively enabled and constrained by past actions and the podcasting production context. Constrabling describes moments of simultaneous opportunity and restriction that occur as radio traditions meet innovative podcasting practices. [ABSTRACT FROM AUTHOR]

Background: Aboriginal language interpreters are under-utilised in healthcare in northern Australia. Self-discharge from hospital is an adverse outcome occurring at high rates among Aboriginal people, with poor communication thought to be a contributor. We previously reported increased Aboriginal interpreter uptake and decreased rates of self-discharge during implementation of a 12-month hospital-based intervention. Interrupted time-series analysis showed sudden increase and up-trending improvement in interpreter use, and a corresponding decrease in self-discharge rates, during a 12-month intervention period (April 2018—March 2019) compared with a 24-month baseline period (April 2016 –March 2018). This paper aims to investigate reasons for these outcomes and explore a potential causal association between study activities and outcomes. Methods: The study was implemented at the tertiary referral hospital in northern Australia. We used the Template for Intervention Description and Replication (TIDieR) as a framework to describe intervention components according to what, how, where, when, how much, tailoring, modifications and reach. Components of the study intervention were: employment of an Aboriginal Interpreter Coordinator, 'Working with Interpreters' training for healthcare providers, and championing of interpreter use by doctors. We evaluated the relative importance of intervention components according to TIDieR descriptors in relation to outcomes. Activities independent of the study that may have affected study findings were reviewed. The relationship between proportion of hospital separations among Aboriginal people ending in self-discharge and numbers of Aboriginal interpreter bookings made during April 2016-March 2019 was tested using linear regression. 'Working with Interpreters' training sessions were undertaken at a regional hospital as well as the tertiary hospital. Training evaluation comprised an anonymous online survey before the training, immediately after and then at six to eight months. Survey data from the sites were pooled for analysis. Results: Employment of the Aboriginal Interpreter Coordinator was deemed the most important component of the intervention, based on reach compared to the other components, and timing of the changes in outcomes in relation to the employment period of the coordinator. There was an inverse association between interpreter bookings and self-discharge rate among Aboriginal inpatients throughout the baseline and intervention period (p = 0.02). This association, the timing of changes and assessment of intercurrent activities at the hospital indicated that the study intervention was likely to be casually related to the measured outcomes. Conclusions: Communication in healthcare can be improved through targeted strategies, with associated improvements in patient outcomes. Health services with high interpreter needs would benefit from employing an interpreter coordinator. [ABSTRACT FROM AUTHOR]