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      Assessing the quality of health research from an Indigenous perspective: the Aboriginal and Torres Strait Islander quality appraisal tool

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          Abstract

          Background

          The lack of attention to Indigenous epistemologies and, more broadly, Indigenous values in primary research, is mirrored in the standardised critical appraisal tools used to guide evidence-based practice and systematic reviews and meta-syntheses. These critical appraisal tools offer no guidance on how validity or contextual relevance should be assessed for Indigenous populations and cultural contexts. Failure to tailor the research questions, design, analysis, dissemination and knowledge translation to capture understandings that are specific to Indigenous peoples results in research of limited acceptability and benefit and potentially harms Indigenous peoples. A specific Aboriginal and Torres Strait Islander Quality Appraisal Tool is needed to address this gap.

          Method

          The Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT) was developed using a modified Nominal Group and Delphi Techniques and the tool’s validity, reliability, and feasibility were assessed over three stages of independent piloting. National and international research guidelines were used as points of reference. Piloting of the Aboriginal and Torres Strait Islander QAT with Aboriginal and Torres Strait Islander and non-Indigenous experts led to refinement of the tool.

          Results

          The Aboriginal and Torres Strait Islander QAT consists of 14 questions that assess the quality of health research from an Aboriginal and Torres Strait Islander perspective. The questions encompass setting appropriate research questions; community engagement and consultation; research leadership and governance; community protocols; intellectual and cultural property rights; the collection and management of research material; Indigenous research paradigms; a strength-based approach to research; the translation of findings into policy and practice; benefits to participants and communities involved; and capacity strengthening and two-way learning. Outcomes from the assessment of the tool’s validity, reliability, and feasibility were overall positive.

          Conclusion

          This is the first tool to appraise research quality from the perspective of Indigenous peoples. Through the uptake of the Aboriginal and Torres Strait Islander QAT we hope to improve the quality and transparency of research with Aboriginal and Torres Strait Islander peoples, with the potential for greater improvements in Aboriginal and Torres Strait Islander health and wellbeing.

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          Most cited references10

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          Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study

          Background Aboriginal and Torres Strait Islander people with chronic illness confront multiple challenges that contribute to their poor health outcomes, and to the health disparities that exist in Australian society. This study aimed to identify barriers and facilitators to care and support for Aboriginal and Torres Strait Islander people with chronic illness. Methods Face-to-face in-depth interviews were conducted with Aboriginal and Torres Strait Islander people with diabetes, chronic heart failure or chronic obstructive pulmonary disease (n-16) and family carers (n = 3). Interviews were transcribed verbatim and the transcripts were analysed using content analysis. Recurrent themes were identified and these were used to inform the key findings of the study. Results Participants reported both negative and positive influences that affected their health and well-being. Among the negative influences, they identified poor access to culturally appropriate health services, dislocation from cultural support systems, exposure to racism, poor communication with health care professionals and economic hardship. As a counter to these, participants pointed to cultural and traditional knowledge as well as insights from their own experiences. Participants said that while they often felt overwhelmed and confused by the burden of chronic illness, they drew strength from being part of an Aboriginal community, having regular and ongoing access to primary health care, and being well-connected to a supportive family network. Within this context, elders played an important role in increasing people’s awareness of the impact of chronic illness on people and communities. Conclusions Our study indicated that non-Indigenous health services struggled to meet the needs of Aboriginal and Torres Strait Islander people with chronic illness. To address their complex needs, health services could gain considerably by recognising that Aboriginal and Torres Strait Islander patients have a wealth of cultural knowledge at their disposal. Strategies to ensure that this knowledge is integrated into care and support programs for Aboriginal and Torres Strait Islander people with chronic illness should achieve major improvements.
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            Indigenous Research Methods: A Systematic Review

            Indigenous communities and federal funding agencies in Canada have developed policy for ethical research with Indigenous Peoples. Indigenous scholars and communities have begun to expand the body of research regarding their peoples, and novel and innovative methods have begun to appear in the published literature. This review attempts to catalogue the wide array of Indigenous research methods in the peer-reviewed literature and describe commonalities among methods in order to guide researchers and communities in future method development. A total of 64 articles met inclusionary criteria and five themes emerged: General Indigenous Frameworks, Western Methods in an Indigenous Context, Community-Based Participatory Research, Storytelling, and Culture-Specific Methods.
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              Dirty questions: Indigenous health and 'Western research'.

              K Humphery (2001)
              This paper explores both Indigenous and non-indigenous critiques of 'Western' research frameworks in an Aboriginal health context. It also discusses the 'reform' of Aboriginal health research practices since the 1980s, particularly in relation to the development of ethical guidelines. The text is based on both archival research and a critical review of secondary literature. It is argued here that efforts to reform the practices of mainstream Indigenous health research since the 1980s have oscillated between taking concrete steps towards actually changing research practice and placing too great a reliance on written guidelines and positive rhetoric. In offering this analysis, the paper argues for a more challenging conception of reforming mainstream research, involving an emphasis on shifts in institutional arrangements as well local research practices.
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                Author and article information

                Contributors
                stephen.harfield@sahmri.com
                odette.pearson@sahmri.com
                kim.morey@sahmri.com
                elnatki1112@gmail.com
                karla.canuto@sahmri.com
                karen.glover@sahmri.com
                judith.gomersall@sahmri.com
                drew.carter@adelaide.edu.au
                carol.davy111@gmail.com
                ed.aromataris@adelaide.edu.au
                abmayer@uow.edu.au
                Journal
                BMC Med Res Methodol
                BMC Med Res Methodol
                BMC Medical Research Methodology
                BioMed Central (London )
                1471-2288
                10 April 2020
                10 April 2020
                2020
                : 20
                : 79
                Affiliations
                [1 ]GRID grid.430453.5, Wardliparingga Aboriginal Health Research Unit, , South Australian Health and Medical Research Institute, ; PO Box 11060, Adelaide, South Australia 5001 Australia
                [2 ]GRID grid.1010.0, ISNI 0000 0004 1936 7304, School of Public Health, , The University of Adelaide, ; Adelaide, Australia
                [3 ]GRID grid.430453.5, Healthy Mothers, Babies and Children, , South Australian Health and Medical Research Institute, ; Adelaide, Australia
                [4 ]GRID grid.1058.c, ISNI 0000 0000 9442 535X, Murdoch Children’s Research Institute, ; Melbourne, Australia
                [5 ]GRID grid.1010.0, ISNI 0000 0004 1936 7304, Joanna Brigg Institute, The University of Adelaide, ; Adelaide, Australia
                [6 ]GRID grid.1010.0, ISNI 0000 0004 1936 7304, Adelaide Health Technology Assessment, , The University of Adelaide, ; Adelaide, Australia
                [7 ]GRID grid.1007.6, ISNI 0000 0004 0486 528X, School of Health and Society, , University of Wollongong, ; Wollongong, Australia
                Article
                959
                10.1186/s12874-020-00959-3
                7147059
                32276606
                8c118102-fd39-443f-b118-a3b44ad9a12d
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 29 April 2019
                : 26 March 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;
                Award ID: NHMRC No 1061242
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Medicine
                aboriginal and torres strait islander people,indigenous,australia,indigenous epistemologies,quality appraisal,systematic reviews,meta-syntheses

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