Susan Elizabeth Smith

In response to ongoing concerns about Sudden Unexpected Death in Infancy (SUDI) amongst Aboriginal and Torres Strait Islander infants, a targeted safe sleep education package which adopted Aboriginal culturally appropriate language was delivered to health professionals working with Aboriginal and Torres Strait Islander families. This initiative accompanied the rollout of the Pēpi‐Pod as a culturally responsive safe sleep alternative. The aim of this study was to conduct a safe sleep education blitz to health professionals to evaluate the effectiveness of the education blitz in enhancing clinical knowledge of safe sleep practices. Surveys were administered to health professionals both before and after the education blitz to assess changes in knowledge and evaluate the effectiveness of the intervention. The mean knowledge score increased from 8.6 (SD = 2.56) pre‐intervention to 9.5 (SD = 1.22) post‐intervention, indicating a positive trend in knowledge acquisition. However, this improvement was not statistically significant. The most notable improvement was seen in responses to the question, “What weakens a baby's arousal response?” where correct answers increased from 83% pre‐intervention to 100% post‐intervention. The education blitz proved to be promising in enhancing safe sleep knowledge and increasing awareness of the Pēpi‐Pod Program as a safe sleep alternative. While health and care professionals demonstrated a high level of understanding, particularly regarding infant arousal and breathing physiology, further improvement could be achieved through continued access to the education blitz. Further evaluation with a larger sample size or over longer time frames is required to confirm these findings.

First Nations families continue to endure profound trauma stemming from the disproportionately high rates of infant (<1 year old) removal, exacerbated by culturally unsafe practices and inadequate support from midwives. This scoping review examines existing literature on the experiences of First Nations families who experience removal of an infant, as well as the perspectives of midwives involved in these removals. A scoping review of online databases identified primary qualitative, or mix-method studies published between 2002 and 2025. Seven publications from Australia, Canada and the United States met the inclusion criteria. Five key themes emerged from the review: (1) The colonial legacy; (2) “It is because I am Aboriginal you know”; (3) The intense emotional toll; (4) No control and (5) The power of honesty. The findings highlight the pervasive absence of culturally safe practices during infant removals and reveal significant challenges midwives face in delivering culturally safe, women-centred care to First Nations families.

Aim: The aim of this study was to explore the role of Endorsed Midwives employed in an Aboriginal Medical Service (AMS) and to assess the impact on Aboriginal mothers and babies using the service. Background: Current research on the role of the Endorsed Midwife (EM) is limited, with no available evidence regarding its application in an AMS setting. Health disparities persist in the outcomes of Aboriginal and non‐Aboriginal mothers and babies. Aboriginal Community‐Controlled Health Organisation (ACCHO) strives to address these challenges by providing culturally safe maternity care. However, there is minimal evidence on the effectiveness of EMs in AMS settings. Method: This study used yarning to conduct interviews with EMs and Yorgas receiving care in an AMS in Western Australia. Results: Key themes identified from the EMs included greater job satisfaction, increased flexibility to deliver holistic care and enhanced collaboration within the multidisciplinary team. In contrast, the Yorgas emphasised the development of trusting relationships with the EMs and their appreciation for culturally appropriate, continuous care. Conclusions: This study provides a holistic perspective on the role of EMs in AMS settings, contributing valuable knowledge to EMs' practice while amplifying the voices of Yorgas who accessed the AMS. Implications for the Profession: The results of this study indicate that EMs possess enhanced capacity and flexibility in their roles, which contributes to greater job satisfaction whilst better meeting the needs of Yorgas' birthing in AMSs. Impact: This study explored the impact of Endorsed Midwives in an AMS. Endorsed midwives achieved greater job satisfaction and were well received by Aboriginal patients. This research increased knowledge of the benefits of Endorsed Midwives employed in an AMS, thereby enhancing the care of Aboriginal clients. Reporting Method: This study adhered to the SQRQ guidelines for reporting qualitative research. Patient/Public Contribution: The study was overseen by an Aboriginal advisory circle, who actively participated in the research process with a focus on culturally appropriate ways of knowing, being and doing research. The Advisory circle was involved from conception and design to data acquisition, analysis, as well as interpretation of data.

Aboriginal women and their infants face substantial health disparities compared to non-Aboriginal women and their infants. Timely, effective, and culturally appropriate maternal and child healthcare can address these inequalities. However, many Aboriginal women experience fear and anxiety when using mainstream healthcare services, leading to lower attendance at perinatal appointments, often due to inadequate communication, poor service coordination, and a lack of continuity in care. This research sought to explore factors that contribute to continuity of care and to consider service features that contribute to positive care experiences and satisfaction with care received by Aboriginal women and their infants. This qualitative study used yarning to explore the experiences and perceptions of care of nine Aboriginal families. Three main themes were identified: (1) Bringing culture to the centre of healthcare with subthemes; (2) Care is lost when you get jumbled around, and (3) In and out for check-ups, scans, and things—no one asked if I needed help. The findings of this research highlight a lack of continuity of care for Aboriginal families accessing mainstream health care services in South Australia, from the antenatal period through to an infants’ first 2000 days of life. This research identified strategies for enhancing continuity, enabling communities and healthcare services to provide appropriate and culturally safe care. By implementing culturally safe and appropriate care, health disparities can be reduced, maternal and child health outcomes may improve, and trust can be fostered between Aboriginal communities and mainstream healthcare services.

Research involving Indigenous communities has been traditionally dominated by Western methodologies which may not fully capture Indigenous perspectives, often marginalising Indigenous knowledge systems and voices. Employing Indigenous data analysis methods supports decolonising interpretation of research data and supports a decolonised approach. This review aimed to identify what Indigenous research data analysis methods exist. Searches were conducted on Medline (via Ovid SP), PsycINFO (via Ovid SP), Web of Science (Clarivate Analytics ) , Scopus (Elsevier), Cumulated Index to Nursing and Allied Health Literature CINAHL (EBSCOhost), ProQuest Central, ProQuest Social Sciences Premium (Clarivate). ProQuest (Theses and Dissertations) were searched for unpublished material. This review identified 17 studies that integrated four Indigenous data Analysis methods: The Kaupapa Māori framework, Yarning method, Talking Circles and NAKPA method (Cree words meaning Medicine/Healing Stories, picked, sorted and stored). A further method “Thought Ritual” is discussed but remains untested in primary research hence was not included in this review. While decolonising research methodologies are growing in use, there is a significant gap in Indigenous data analysis methods.

Background: Immunization is one of the most significant health initiatives of recent times. Despite this, vaccine hesitancy is increasing and was listed as one of the top 10 threats to global health by the World Health Organization in 2019. A major factor associated with vaccine hesitancy is thought to be the viral spread of misinformation by a small but active anti-vaccination movement. Objectives: The purpose of this study was to explore the influences of social media on vaccine decision-making in parents. Design: This study is part of a larger body of research that explored vaccine decision-making in parents. Other methods included were an online survey and semi-structured interviews. This study investigated the influence of cyberculture on parents in an online environment. Method: This study employed netnography, a form of qualitative inquiry with its roots in ethnography as methodology and a purpose-designed Facebook page as the means of exploring a purpose-designed online community with a particular focus on the culture, belief systems and influences present. Both manual and computer-assisted thematic analyses were used to analyse the data obtained. Results: Three key themes were identified in this study. These included vaccine safety concerns, the emotional debate and COVID-19-specific issues. The results indicated the presence of strong anti-vaccination sentiment combined with an ‘infodemic’ of conspiracy theories, misinformation and vitriol with the potential to negatively impact parents seeking immunization information. Conclusion: Given the popularity and accessibility of social media and the ready access to misinformation present online, it is evident that parental vaccine decision-making may be impacted adversely. Therefore, it is important that healthcare professionals are aware of this and provide adequate and timely education prior to parents seeking information on social media.

Aim: The aim of this paper is to critically reflect on our team's experience of using netnography to explore vaccine‐hesitant parents and pregnant women, a group who have traditionally been difficult to recruit to research studies and a methodology that is underutilized in nursing research.Design: This paper takes the form of a discussion paper that will utilize data obtained from a qualitative netnographic study. Relevant literature was searched including 2015–2023.Method: This paper utilized data obtained from a qualitative study that used netnography as methodology and an online minable data source. Netnography is a relatively new methodology that uses the online environment to explore digital cultures and study networked society. It pays particular attention to cultural insights and conditions that impact the human experience. This methodology is particularly relevant to nursing research which is often humanistic and always conducted to ensure optimal patient outcomes.Results: Using netnography for the first time has resulted in four main insights. These include the adaptability of the process; the creativity involved in designing the site; the ready acceptance of the site by participants and the co‐creation knowledge that resulted.Conclusions: Netnography is a creative methodology that was successful in accessing and engaging the vaccine‐hesitant community, a group who are often marginalized. Netnography has the advantage of using a platform that is familiar and safe for many people and provides access to an extensive minable data source.

Vaccine hesitancy has been described as any delay or refusal of vaccines despite their availability and is increasing in Australia and other middle to high-income countries. The aim of this study is to gain a deep understanding of the experiences and influences on vaccine hesitant children and their families. A qualitative interview approach was undertaken with vaccine hesitant parents and pregnant women (n = 12). Semi-structured interviews were conducted by telephone. Inductive thematic analysis was undertaken on data obtained using the guidelines of Braun and Clarke. Three main themes were identified in this study, including Pushed to the fringe; A culture of Distrust; and Coerced choices. The study revealed that vaccine hesitant parents felt isolated and pushed to the fringe of society. They also expressed dissatisfaction with the Australian "No Jab - No Pay" and "No Jab - No Play" legislation. This contributed to feelings of marginalization. Participants also cited a breakdown in the therapeutic relationships, which impacted their child's health. Additionally, a lack of sufficient information was received to achieve informed consent. These results suggest that there is a need for enhanced education for some health-care professionals, many of whom have reported being confronted by conversations with vaccine hesitant parents.