1192447_Stearne,A_2022.pdf (1.32 MB)
First Nations Australians’ self-determination in health and alcohol policy development: a Delphi study
journal contribution
posted on 2022-07-28, 02:10 authored by A E. Stearne, Kylie LeeKylie Lee, S Allsop, A Shakeshaft, M WrightBackground: Recognition of the role of structural, cultural, political and social determinants of health is increasing. A key principle of each of these is self-determination, and according to the United Nations (2007), this is a right of Indigenous Peoples. For First Nations Australians, opportunities to exercise this right appear to be limited. This paper explores First Nations Australian communities’ responses to reducing alcohol-related harms and improving the health and well-being of their communities, with a focus on understanding perceptions and experiences of their self-determination. It is noted that while including First Nations Australians in policies is not in and of itself self-determination, recognition of this right in the processes of developing health and alcohol policies is a critical element. This study aims to identify expert opinion on what is needed for First Nations Australians’ self-determination in the development of health- and alcohol-related policy. Methods: This study used the Delphi technique to translate an expert panel’s opinions into group consensus. Perspectives were sought from First Nations Australians (n = 9) and non-Indigenous Peoples (n = 11) with experience in developing, evaluating and/or advocating for alcohol interventions led by First Nations Australians. Using a web-based survey, this study employed three survey rounds to identify and then gain consensus regarding the elements required for First Nations Australians’ self-determination in policy development. Results: Twenty panellists (n = 9 First Nations Australian) participated in at least one of the three surveys. Following the qualitative round 1 survey, six main themes, 60 subthemes and six examples of policy were identified for ranking in round 2. In round 2, consensus was reached with 67% of elements (n = 40/60). Elements that did not reach consensus were repeated in round 3, with additional elements (n = 5). Overall, consensus was reached on two thirds of elements (66%, n = 43/65). Conclusions: Self-determination is complex, with different meaning in each context. Despite some evidence of self-determination, systemic change in many areas is needed, including in government. This study has identified a starting point, with the identification of elements and structural changes necessary to facilitate First Nations Australian community-led policy development approaches, which are vital to ensuring self-determination.
Funding
This work was supported by the National Health and Medical Research Council, Centre of Research Excellence: Indigenous Health and Alcohol (ID#:1117198). The National Drug Research Institute at Curtin University and the National Drug and Alcohol Research Centre at the University of New South Wales are supported by funding from the Australian Government under the Drug and Alcohol Program. The funders have no involvement in the design, data collection or analysis; writing of the report, or decision to submit for publication.
History
Publication Date
2022-12-01Journal
Health Research Policy and SystemsVolume
20Issue
1Article Number
ARTN 12Pagination
16p.Publisher
BMCISSN
1478-4505Rights Statement
© The Author(s) 2022. This 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. 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.Publisher DOI
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- Public health not elsewhere classified
- Aboriginal and Torres Strait Islander health and wellbeing not elsewhere classified
- Aboriginal and Torres Strait Islander health policy
- Aboriginal and Torres Strait Islander political participation and representation
- Aboriginal and Torres Strait Islander social impact and program evaluation
- Sociology not elsewhere classified
Keywords
Science & TechnologyLife Sciences & BiomedicineHealth Policy & ServicesHealth Care Sciences & ServicesFirst Nations AustraliansAustraliaSelf-determinationPolicy developmentRightsAlcoholINDIGENOUS PEOPLESRIGHTSDECLARATIONQUALITYIMPACTDelphi TechniqueHumansNative Hawaiian or Other Pacific IslanderPersonal AutonomyPublic PolicyPublic Health and Health Services not elsewhere classifiedAboriginal and Torres Strait Islander HealthAboriginal and Torres Strait Islander PolicySociology
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