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Background Aboriginal and Torres Strait Islander peoples have a unique place in Australia as the original inhabitants of the land. Similar to other First Nations people globally, they experience a disproportionate burden of injury and chronic health conditions. Discharge planning ensures ongoing care to avoid complications and achieve better health outcomes. Analysing discharge interventions that have been implemented and evaluated globally for First Nations people with an injury or chronic conditions can inform the implementation of strategies to ensure optimal ongoing care for Aboriginal and Torres Strait Islander people. Methods A systematic review was conducted to analyse discharge interventions conducted globally among First Nations people who sustained an injury or suffered from a chronic condition. We included documents published in English between January 2010 and July 2022. We followed the reporting guidelines and criteria set in Preferred Reporting Items for Systematic Review (PRISMA). Two independent reviewers screened the articles and extracted data from eligible papers. A quality appraisal of the studies was conducted using the Mixed Methods Appraisal Tool and the CONSIDER statement. Results Four quantitative and one qualitative study out of 4504 records met inclusion criteria. Three studies used interventions involving trained health professionals coordinating follow-up appointments, linkage with community care services and patient training. One study used 48-hour post discharge telephone follow-up and the other text messages with prompts to attend check-ups. The studies that included health professional coordination of follow-up, linkage with community care and patient education resulted in decreased readmissions, emergency presentations, hospital length of stay and unattended appointments. Conclusion Further research on the field is needed to inform the design and delivery of effective programs to ensure quality health aftercare for First Nations people. We observed that discharge interventions in line with the principal domains of First Nations models of care including First Nations health workforce, accessible health services, holistic care, and self-determination were associated with better health outcomes. Registration This study was prospectively registered in PROSPERO (ID CRD42021254718).

IntroductionParents of children hospitalised in a burn unit experience psychological trauma and later post-traumatic stress. Aboriginal and Torres Strait Islander families whose child has been admitted to a burn unit encounter additional burdens through a culturally unsafe healthcare system. Psychosocial interventions can help reduce anxiety, distress and trauma among children and parents. There remains a lack of interventions or resources that reflect Aboriginal and Torres Strait Islander people’s perspective of health. The objective of this study is to codevelop a culturally appropriate informative resource to assist Aboriginal and Torres Strait Islander parents whose child has been hospitalised in a burn unit.MethodsIn this participatory research study, the development of a culturally safe resource will build on Aboriginal and Torres Strait Islander families’ experiences and voices, complemented by the knowledge and expertise of an Aboriginal Health Worker (AHW) and burn care experts. Data will be collected through recorded yarning sessions with families whose child has been admitted to a burn unit, the AHW and burn care experts. Audiotapes will be transcribed and data will be analysed thematically. Analysis of yarning sessions and resource development will follow a cyclical approach.Ethics and disseminationThis study has been approved by the Aboriginal Health and Medical Research Council (AH&MRC) (1690/20) and the Sydney Children’s Hospitals Network ethics committee (2020/ETH02103). Findings will be reported to all participants and will be disseminated with the broader community, the funding body and health workers at the hospital. Dissemination with the academic community will be through peer-reviewed publications and presentations in relevant conferences.

To undertake a descriptive analysis of the Aboriginal and Torres Strait Islander Health Worker workforce to quantify the changes from 2006–2016. We analysed data on Indigenous Health Workers from three waves of Australian Census: 2006, 2011 and 2016. We described the workforce by gender, age and state/territory. There has been overall growth in the number of Indigenous Health Workers (from 1,009 in 2006 to 1,347 in 2016), but this is not commensurate with Aboriginal and Torres Strait Islander population growth (221 Indigenous Health Workers per 100,000 people in 2006 to 207 Indigenous Health Workers per 100,000 people in 2016). The growth is in Indigenous Health Workers aged ≥45 years, with declines in the proportion of Indigenous Health Workers aged ≤44 years. There was growth in workers in two states only, Queensland (increase 4.2 percentage points) and New South Wales (increase 6.6 percentage points). There are pressing concerns regarding the lack of growth and the ageing workforce of Aboriginal and Torres Strait Islander Health Workers. We remain concerned that little is being done to increase the retention and recruitment of this workforce. Greater effort is needed to improve the recruitment and retention of Aboriginal and Torres Strait Islander Health Workers, particularly for younger age groups and males. A National Aboriginal and Torres Strait Islander Health Workforce Strategy needs to be implemented.

Shared Decision Making (SDM) in healthcare is a patient-centred approach that acknowledges the importance of involving patients in healthcare decisions. SDM is gaining prominence, it often overlooks the perspectives of Indigenous populations. This abstract explores the crucial need for establishing a global foundation incorporating Indigenous health perspectives into SDM.Indigenous communities worldwide confront distinct healthcare challenges due to historical disparities, cultural disparities, and socioeconomic factors. Integrating Indigenous voices, values, and traditional knowledge into healthcare decision-making is vital for achieving equitable health outcomes. However, current healthcare systems often need to address these issues more.This initiative proposes creating a global network that collaborates with Indigenous communities, international leaders, and healthcare experts to advance Indigenous health perspectives within the SDM framework. The network’s objectives include: Promoting Cultural Competence: Understanding Indigenous cultures and traditions among healthcare providers and policymakers to integrate cultural competence into SDM. Empowering Indigenous Communities: Through capacity-building initiatives and education, Indigenous communities can actively engage in healthcare decision-making, ensuring alignment with values and preferences. Bridging Knowledge Gaps: Facilitating research and knowledge-sharing to bridge the divide between Western medical knowledge and Indigenous traditional healing practices, enabling a holistic healthcare approach. Advocating for Policy Change: Serving as a platform for advocating policy changes prioritising Indigenous health perspectives and addressing healthcare disparities. Promoting Ethical and Inclusive Practices: Centralising ethical considerations, including informed consent and respect for Indigenous data sovereignty, to uphold the rights and dignity of Indigenous populations.Establishing a global foundation for Indigenous health perspectives within SDM is crucial for fostering more inclusive and equitable healthcare systems. This represents a pivotal step toward ensuring that healthcare decisions genuinely reflect all patients‘ diverse needs and viewpoints, including Indigenous populations. It aims to enhance health outcomes and cultivate a fairer, more inclusive healthcare environment for Indigenous communities worldwide.

Background: Aboriginal and Torres Strait Islander women deserve improved smoking cessation support. Aboriginal health workers (AHW) and practitioners (AHP) can be central to the provision of culturally safe smoking cessation care (SCC). The objective of this study is to explore attitudes and the perceived role of AHWs/AHPs toward providing SCC to Aboriginal and Torres Strait Islander pregnant women. Method: A mixed-method study using quantitative and qualitative data was conducted among AHW/AHPs in 2021 across Australia. Descriptive and analytical statistics were used to characterise AHWs’/AHPs’ attitudes towards SCC and to evaluate the factors associated with perceptions of who is best placed to provide SCC. Results: From the total AHW/AHP workforce, 21.2% (223) completed the survey. Less than half (48.4%) believed that AHW/AHP were best placed to provide SCC for pregnant women. The majority believed that group-based supports (82.5%) and cultural support programs (63.7%) were the best strategies to support Aboriginal and Torres Strait Islander pregnant women to quit smoking. Conclusion: This study highlights the need to enhance SCC offered to Aboriginal and Torres Strait Islander pregnant women. A targeted workforce dedicated to smoking cessation should be resourced, including funding, standardised training, and ongoing SCC support tailored to Aboriginal and Torres Strait Islander pregnant women.

IntroductionThe pivotal role played by Aboriginal and Torres Strait Islander Health Workers and Health Practitioners (ATSIHW&P) in facilitating Shared Decision-Making (SDM) with patients, particularly within Indigenous communities in Australia. This emphasises the significance of culturally competent care and their unique perspectives; this study explores the multifaceted roles of these Health Workers in SDM.MethodsOur research methodology involved an extensive review of the contributions of Aboriginal and Torres Strait Islander Health Workers in healthcare settings, coupled with consultations with healthcare professionals, community members, and ATSIHW&P themselves to gain comprehensive insights into their involvement in SDM.ResultsThe study highlights several critical roles that ATSIHW&P fulfil in SDM, including acting as cultural liaisons, promoting cultural competence, facilitating effective communication, advocating for patients‘ rights, providing health education, and actively engaging in SDM discussions. Collectively, these roles enhance the patient experience, promote health literacy, and empower patients to make informed healthcare decisions.DiscussionOur discussion underscores the cultural competence of ATSIHW&P and their ability to bridge the gap between patients and healthcare providers. They create culturally safe environments, ensure patients‘ voices are heard, and offer emotional support during challenging healthcare decisions. Their roles extend to care coordination, community engagement, and fostering trust and confidence among patients.ConclusionAboriginal and Torres Strait Islander Health Workers play an instrumental role in promoting SDM in healthcare settings. Their roles encompass cultural competence, advocacy, communication, and patient empowerment. Recognising their value in SDM is essential for patient-centred care and improved health outcomes, particularly within Indigenous communities. Culturally safe healthcare environments, empowered patients, and enhanced health literacy are outcomes that underscore the importance of ATSIHW&P in SDM. This study emphasises the need to acknowledge, support, and further integrate their roles to ensure culturally efficient, effective, and appropriate healthcare decision-making for Aboriginal and Torres Strait Islander patients.

Severe injury and chronic conditions require long-term management by multidisciplinary teams. Appropriate discharge planning ensures ongoing care to mitigate the long-term impact of injuries and chronic conditions. However, First Nations peoples in Australia face ongoing barriers to aftercare. This systematic review will locate and analyse global evidence of discharge interventions that have been implemented to improve aftercare and enhance health outcomes among First Nations people with an injury or chronic condition. A systematic search will be conducted using five databases, Google, and Google scholar. Global studies published in English will be included. We will analyse aftercare interventions implemented and the health outcomes associated. Two independent reviewers will screen and select studies and then extract and analyse the data. Quality appraisal of the included studies will be conducted using the Mixed Methods Appraisal Tool and the CONSIDER statement. The proposed study will analyse global evidence on discharge interventions that have been implemented for First Nations people with an injury or chronic conditions and their associated health outcomes. Our findings will guide healthcare quality improvement to ensure Aboriginal and Torres Strait Islander peoples have ongoing access to culturally safe aftercare services.