James Ward

This study examined the benefits and outcomes of the Yarning for Success (YfS) Program – an initiative led by the University of Queensland’s Poche Centre for Indigenous Health to support the recruitment and retention of First Nations Australian early career academics (ECAs). Qualitative interview data from seven of the nine program participants was analysed from an Indigenous standpoint using narrative inquiry. The life experiences of First Nations Australian ECAs shaped their journey into the academy. Key benefits of the YfS Program were culturally safe spaces, strong and nurturing leadership and support, and transformative connections and networks. Of the seven First Nations Australian ECAs interviewed, five have conferred and one has passed their PhD. Racial microaggressions created peer and institutional expectations for some First Nations Australian ECAs to undertake additional work because of their Indigenous identity. Enhancing the benefits and outcomes of the YfS Program for First Nations Australian ECAs requires the implementation of university wide anti-racist strategies.

Background: Assessing patient perspectives is fundamental to determining whether anti-racism and cultural training programs and services associated with an intervention achieve their intended outcomes, yet reviews frequently focus on health provider perspectives. This systematic review, therefore, aimed to investigate First Nations Peoples’ experiences, as patients, of interventions to improve their Cultural Safety and experiences in secondary and tertiary healthcare settings. Methods: American Psychological Association’s PsycInfo (via EBSCOhost), Cumulative Index to Nursing and Allied Health Literature Complete (via EBSCOhost), PubMed, and Scopus (via Elsevier) were all searched from inception to 9 December 2025. Eligible intervention studies needed to report the experiences of First Nations’ people as care recipients in secondary and tertiary healthcare settings. Eligible study countries were Australia, Canada, Aotearoa (New Zealand), and the United States of America (USA). General study quality was assessed using the Mixed Methods Appraisal Tool. Study quality was also examined with a modified version of the Aboriginal and Torres Strait Islander Quality Appraisal Tool to provide a First Nations perspective. Qualitative meta-aggregation was conducted to synthesize both qualitative and quantitative data. Results: There were 22 reports (11 qualitative, 7 quantitative, and 4 mixed methods) of 20 eligible studies, including 2092 First Nations care recipients. Interventions and quantitative outcomes were heterogeneous, precluding meta-analysis. Four studies reported on cultural training for health professionals, with the remainder service-level interventions. The qualitative meta-aggregation resulted in six synthesized findings, which reflected the mechanisms by which these programs worked and their outcomes. Four synthesized findings described mechanisms. These included emotional and practical support; acknowledgement, respect, and support for culture; feeling accepted, heard, valued, safe, comfortable, and respected; and navigating treatment and the system. The two synthesized findings related to outcomes concerned perceptions of health services and, relatedly, impacts on health service access. Quality appraisal revealed no discussion of existing and newly created intellectual property considerations. Study limitations included undefined terminology, terms being used interchangeably, and a few studies from the USA and Aotearoa (New Zealand). Conclusions: Published intervention studies assessing First Nations care recipients’ experiences appear to be increasing. Future interventions must clearly define the terminology in the intervention, use mixed-methods approaches, and report intellectual property considerations. Trial registration: Systematic review: PROSPERO, CRD42024521218 (prospective, available at https://www.crd.york.ac.uk/PROSPERO/view/CRD42024521218).

Background: The urban First Nations population in Australia is rapidly increasing. The health policy and research focus on urban First Nations Australians, however, is limited. To contribute to addressing this situation, The University of Queensland Poche Centre for Indigenous Health (UQ Poche Centre), a First Nations-led health research centre, is working closely with urban Aboriginal Community-Controlled Health Services (ACCHS) across Australia. Aim: Our study examined urban ACCHSs stakeholders’ perspectives of the health and wellbeing of urban First Nations Australians and identified their priorities for a national Indigenous urban health research agenda. Methods: Ten stakeholders were recruited for in-depth interviews from ACCHS that were members of the Research Alliance for Urban Community-Controlled Health Services (RAUCCHS), a partnership between the UQ Poche Centre and urban ACCHS focused on achieving equitable health outcomes for urban First Nations Australians. Six stakeholders identified as First Nations Australians. Interviews were audio-recorded and transcribed verbatim. Interview data were analysed using inductive thematic analysis. Results: Stakeholders highlighted a lack of research focused on the health of urban First Nations Australians. Specific priority areas they identified for an urban First Nations health research agenda were: evaluating the effectiveness and adaptability of Indigenous models of care, strengthening care pathways between ACCHS and specialist services, examining the intersection of cultural identity, racism and determinants of health, and greater investment in Indigenous research governance structures and processes. Conclusions: There is a clear opportunity for researchers to engage with RAUCCHS members to establish a body of urban First Nations health research in Australia that responds to their research priorities.

Background: Preventing and treating methamphetamine-related harm in Aboriginal and Torres Strait Islander populations is a significant challenge for health care services. Digital health care may offer opportunities to support individuals and families in ways that complement existing methamphetamine treatment options. This study responds to a community-identified priority as Aboriginal Community Controlled Health Services identified methamphetamine use as a key concern and sought support to respond to the needs of people who use methamphetamine and their families. Objective: This paper reports on a process evaluation of the web application’s acceptability and feasibility when used by clients and clinicians in residential rehabilitation services and primary care. This study is part of a larger project entitled “Novel Interventions to address Methamphetamine use in Aboriginal and Torres Strait Islander Communities” (NIMAC), which seeks to develop culturally appropriate and strengths-based prevention and treatment interventions to reduce methamphetamine related harm. “We Can Do This” was a web application developed for Aboriginal and Torres Strait Islander people who are seeking to reduce or stop methamphetamine use. Methods: Clinicians and clients who had used the web application were recruited through Aboriginal Community Controlled Health Services and Aboriginal residential rehabilitation services in urban and regional Victoria and South Australia. Unidentified usage data was collected from all participants. After using the web application, those who indicated a willingness to be interviewed were contacted and interviewed by phone or in person and asked about the feasibility and acceptability of the web application. The framework method of analysis was used to structure and summarise the resulting qualitative data. Results: Interviews with 24 clients and 11 clinicians explored the acceptability and feasibility of the web application. Acceptability incorporated the following domains: affective attitude, burden, ethicality, cultural appropriateness, coherence, opportunity cost, perceived effectiveness, and self-efficacy. The evaluation of feasibility assessed barriers and facilitators to the implementation of the program, with a focus on demand, practicality, fidelity, and integration. Results indicated that both clients and clinicians found the web application content coherent, relatable, empowering, and culturally safe. Barriers to using the web application for clients included a lack of internet connectivity and personal issues such as scheduling. Conclusions: Process evaluation is often under-valued. However, as “We Can Do This” was new, innovative and targeted a hard-to-reach population, understanding its feasibility and acceptability as a clinical tool was essential to understanding its potential. “We Can Do This” is unique as the only evidence-based, culturally appropriate internet-based therapeutic program specifically designed for Aboriginal and Torres Strait Islander people who use methamphetamine. Findings suggest it was both acceptable and feasible as a low-cost adjunct to usual care in residential rehabilitation and primary care settings.

Background: Digital interventions can help to overcome barriers to care, including stigma, geographical distance, and a lack of culturally appropriate treatment options. “We Can Do This” is a web-based app that was designed with input from cultural advisors and end users to support Aboriginal and Torres Strait Islander people seeking to stop or reduce their use of methamphetamine and increase psychosocial well-being. Objective: This study aimed to evaluate the effectiveness of the “We Can Do This” web-based app as a psychosocial treatment for Aboriginal and Torres Strait Islander people who use methamphetamine. Methods: The web app was evaluated using a randomized waitlist controlled parallel group trial. Participants were Aboriginal and Torres Strait Islander people aged 16 years or older who self-identified as having used methamphetamine at least weekly for the past 3 months. Participants were randomized on a 1:1 ratio to receive either access to the web-based app for 6 weeks or a waitlist control group. Both groups received access to a website with harm minimization information. The primary outcome was days of methamphetamine use in the past 4 weeks assessed at 1, 2, and 3 months post randomization. Secondary outcomes included severity of methamphetamine dependence (Severity of Dependence Scale [SDS]), psychological distress (Kessler 10 [K10]), help-seeking behavior, and days spent out of role due to methamphetamine use. Results: Participants (N=210) were randomized to receive either access to the web-based app (n=115) or the waitlist control condition (n=95). Follow-up was 63% at 1 month, 57% at 2 months, and 54% at 3 months. There were no significant group differences in days of methamphetamine use in the past 4 weeks at 1 the month (mean difference 0.2 days, 95% CI –1.5 to –2), 2 months (mean difference 0.6 days, 95% CI –1 to 2.4 days) or 3 months (mean difference 1.4 days, 95% CI –0.3 to 3.3 days) follow-up. There were no significant group differences in K10 scores, SDS scores, days out of role, or help-seeking at any of the 3 follow-up timepoints. There was poor adherence to the web-based app, only 20% of participants in the intervention group returned to the web-based app after their initial log-in. Participants cited personal issues and forgetting about the web-based app as the most common reasons for nonadherence. Conclusions: We found poor engagement with this web-based app. The web-based app had no significant effects on methamphetamine use or psychosocial well-being. Poor adherence and low follow-up hindered our ability to accurately evaluate the effectiveness of the web-based app. Future web-based apps for this population need to consider methods to increase participant engagement. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12619000134123p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376088 International Registered Report Identifier (IRRID): RR2-10.2196/14084

Background: This study describes chlamydia and gonorrhoea testing, positivity, treatment, and retesting among individuals aged ≥15 years attending an urban Aboriginal Community Controlled Health Service during the period 2016–2021. Method: Utilising routinely collected clinical data from the ATLAS program (a national sentinel surveillance network), a retrospective time series analysis was performed. The study assessed testing rates, positivity, treatment efficacy, retesting and trends over time within an urban Aboriginal Community Controlled Health Service. Results: Testing rates for chlamydia and gonorrhoea varied between 10 and 30% over the study period, and were higher among clients aged 15–29 years and among females. Positivity rates for both infections varied by age, with clients aged 15–24 years having higher positivity than older clients. Gonorrhoea positivity rates decreased after 2016. Treatment and retesting practices also showed sex disparities, with men having a slightly higher treatment rate within 7 days, whereas females had significantly higher retesting rates within 2–4 months, indicating differences in follow-up care between sexes. Conclusion: The study emphasises the need for clinical and public health interventions within urban Aboriginal and Torres Strait Islander populations to further reduce chlamydia and gonorrhoea. Prioritising improved access to testing, timely treatment and consistent retesting can significantly contribute to lowering STI prevalence and enhancing sexual health outcomes in these communities.

Aims: This study tested the efficacy and safety of a 12‐week course of lisdexamfetamine in reducing methamphetamine use, an outcome which is associated with improvements in health and wellbeing, in people dependent on methamphetamine.Design, setting and participants: This study was a randomised double‐blind placebo‐controlled trial conducted in six specialist outpatient clinics in Adelaide, Melbourne, Newcastle and Sydney, Australia (2018–2021). Participants were164 adults with methamphetamine dependence, reporting at least 14 use days out of the previous 28 days (62% male, 38% female, < 1% other; mean age 39 years).Interventions: Participants were randomly allocated 1:1 to a 15‐week regimen of lisdexamfetamine (1‐week induction to 250 mg, 12‐week maintenance regimen, 2‐week reduction; n = 80) or matched placebo (n = 84), followed‐up to Week 19.Measurements: The primary efficacy measure was past 28‐day methamphetamine use at Week 13. Safety was assessed by adverse event rates. Secondary measures included methamphetamine use during the 12‐week treatment period and treatment satisfaction.Findings: Nine randomized participants did not start treatment (five were allocated to lisdexamfetamine and four allocated to placebo) and were excluded from the analyses. Fifty‐seven per cent of participants were retained on study medication to primary end‐point. There was only weak evidence of a lisdexamfetamine benefit at 13 weeks [adjusted difference in days of methamphetamine use = 2.2, 95% confidence interval (CI) = –0.5 to 5.0; P = 0.49]. However, throughout the whole 12‐week treatment maintenance phase, the lisdexamfetamine group had fewer days of methamphetamine use in total (difference = 8.8, 95% CI = 2.7–15.0; P = 0.005). The lisdexamfetamine group reported greater self‐reported treatment effectiveness [odds ratio (OR) = 2.89, 95% CI = 1.67–5.02; P < 0.001] and treatment satisfaction (OR = 3.80, 95% CI = 1.93–7.47; P < 0.001). Adverse events with lisdexamfetamine included nausea. Serious adverse events occurred in four (5%) of participants who received lisdexamfetamine.Conclusions: Lisdexamfetamine appears to reduce methamphetamine use over a 12‐week treatment period, although there is only weak evidence that reduced use is maintained during the last 4 weeks.

Globally, there is a growing acknowledgment of Indigenous Peoples’ rights to control data related to their communities. This is seen in the development of Indigenous Data Governance standards. As health data collection increases, it’s crucial to apply these standards in research involving Indigenous communities. Our study, therefore, aims to systematically review research using routinely collected health data of Indigenous Peoples, understanding the Indigenous Data Governance approaches and the associated advantages and challenges. We searched electronic databases for studies from 2013 to 2022, resulting in 85 selected articles. Of these, 65 (77%) involved Indigenous Peoples in the research, and 60 (71%) were authored by Indigenous individuals or organisations. While most studies (93%) provided ethical approval details, only 18 (21%) described Indigenous guiding principles, 35 (41%) reported on data sovereignty, and 28 (33%) addressed consent. This highlights the increasing focus on Indigenous Data Governance in utilising health data. Leveraging existing data sources in line with Indigenous data governance principles is vital for better understanding Indigenous health outcomes.

Background: There is increasing recognition of the importance of the preconception period for addressing reproductive and intergenerational health inequities and supporting improved maternal and child health outcomes. This study aimed to understand the extent and type of evidence that exists in relation to preconception health for Indigenous peoples living in high-income countries with similar experiences of colonisation, namely, Australia, New Zealand, Canada, and the United States. Methods: This review was conducted as per the JBI methodology and PRISMA Extension for Scoping Reviews. A comprehensive search of PubMed, CINAHL [EBSCO], Ovid Embase, Scopus, and the Wiley Cochrane Library was conducted using keywords and index terms. We included research in English published between January 2010 and June 2023 on quantitative and qualitative primary studies. Data were extracted using a standardised tool, and the analysis included quantitative descriptions and qualitative content analysis. Results: We identified 360 potential studies and included 57 articles in the review. Most studies were from the United States (n = 36, 63.2%) and Australia (n = 13, 22.8%), and they commonly reported associations between preconception health risk factors and maternal or child health outcomes (n = 27, 48.2%) or described the development, implementation, or evaluation of preconception health interventions (n = 26, 46.4%). Common preconception health areas were pre-pregnancy body mass index or weight (n = 34), alcohol (n = 16), diet (n = 14), physical activity (n = 12), and diabetes (n = 11). Most studies focused exclusively on women (n = 46, 80.7%), and very few included men (n = 3, 5.3%). The study populations were mostly urban and rural (n = 25, 43.9%) or rural only (n = 14, 24.6%); however, the geographical remoteness was often unclear (n = 14, 24.6%). Conclusions: While there was some research relating to the preconception health of Indigenous peoples, this review identified considerable research gaps. There is a need for dedicated research into preconception health risk factors and reproductive health outcomes, attitudes and awareness of preconception health, and preconception health interventions for Indigenous peoples.

BACKGROUND We Can Do This was a web-based application (web-app) developed for Aboriginal and Torres Strait Islander people who are seeking to reduce or stop methamphetamine use. OBJECTIVE This paper reports on a process evaluation of the web-app’s acceptability and feasibility when used by clients and clinicians in residential rehabilitation services and primary care. METHODS Clinicians and clients who had used the web-app were recruited via Aboriginal Community Controlled Health Services and Aboriginal residential rehabilitation services in urban and regional Victoria and South Australia. Non-identified usage data was collected from all participants. After using the web-app, those who indicated a willingness to be interviewed were contacted and interviewed by phone or in person and asked about the feasibility and acceptability of the web-app. RESULTS Interviews with ten clients and eleven clinicians highlighted that both clients and clinicians found the content coherent, relatable, empowering and culturally safe. Barriers to using the web-app for clients included a lack of internet connectivity and personal issues such as scheduling. CONCLUSIONS Process evaluation is often under-valued. However, as We Can Do This was new, innovative and targeted a hard-to-reach population, understanding its feasibility and acceptability as a clinical tool was essential to understanding its potential. We Can Do This is unique as the only evidence-based, culturally appropriate online therapeutic program specifically designed for Aboriginal and Torres Strait Islander people who use methamphetamine. Findings suggest it was both acceptable and feasible as a low-cost adjunct to usual care in residential rehabilitation and primary care settings.