Person, Place and Time: Strengths-based approaches to Aboriginal and Torres Strait Islander Health and Wellbeing
Creators: name: Sedgwick, Mikala
Publisher: name: The Australian National University
Year: 2023

description: This thesis comprises a collection of applied epidemiological studies including an evaluation and epidemiological study, an outbreak investigation, and a data analysis. Research has been conducted in partnership with Aboriginal and Torres Strait Islander individuals, communities, and organisations. The primary focus of this thesis is on Aboriginal and Torres Strait Islander health and wellbeing using a strengths based, mixed methods approach. The first study 'A strengths-based analysis of smoking-related outcomes in the Mayi Kuwayu Study, overall and in relation to remoteness' analysed baseline smoking data from the Mayi Kuwayu National Study of Aboriginal and Torres Strait Islander Wellbeing Study. Smoking is the leading contributor to the burden of disease among Aboriginal and Torres Strait Islander peoples. A descriptive analysis was used to break down results by remoteness level to analyse the patterns of smoking, smoking behaviours, attitudes and beliefs and to identify factors that have assisted Mayi Kuwayu Study participants to successfully quit and be smoke free. The second study examines measuring disability among Aboriginal and Torres Strait Islander peoples. This study is a combined Epidemiology Project; Psychometric validation and evaluation of a public health surveillance system. Disability is a key concern for Aboriginal and Torres Strait Islander peoples, that has not received due attention from research or policy. The establishment of a robust surveillance system to monitor disability prevalence and impacts is a key first step in driving action that can improve wellbeing for Aboriginal and Torres Strait Islander peoples. This action should be led by Aboriginal and Torres Strait Islander peoples and informed by relevant, meaningful data. Without a relevant dedicated disability census or surveillance system, and understanding of the overall picture, estimations of required diagnosis and support needs are hindered. A valid tool to measure disability is necessary to determine the prevalence of disability and its impacts, and the level of diverse needs amongst people with disabilities, along with informing and developing supports, programs and healthcare interventions. This study aimed to evaluate the measures of disability developed for use in the first wave of Mayi Kuwayu: the National Study of Aboriginal and Torres Strait Islander Wellbeing. This included a psychometric validation, and to undertake a consultative process to provide recommendations to make the Mayi Kuwayu disability data a more valuable resource for the Aboriginal and Torres Strait Islander disability community and sector. The final study explored an investigation of a foodborne illness outbreak and search for the causative pathogen associated with a set menu dinner at a restaurant in Canberra, Australian Capital Territory (ACT). Descriptive epidemiology was used to identify the source of the pathogen, and differential diagnosis techniques were applied to hypothesise the most likely agent due to the absence of environmental, food and human specimens for laboratory confirmation. The chapter also describes the public health measures implemented to minimise the risk of future outbreak occurrences within the restaurant. Also described in this thesis are public health experiences gained during my placement. Together, these projects and experiences fulfil the core requirements of the Master of Philosophy (Applied Epidemiology) program at Australian National University.