Why do Indigenous Australians drink and drive? A qualitative exploration of self-reported influences on drink driving behaviours of Indigenous peoples from remote communities

Drink driving contributes towards high injury rates for Indigenous populations in Canada and Australia, particularly in more isolated regions. At present there is limited research on the cultural and psychosocial factors that underpin Indigenous peoples’ drink driving. This study is part of a broader project aiming to inform a culturally sensitive program. Qualitative interviews with 29 convicted Indigenous drink drivers (aged 20-51 years) from a remote region of Queensland, Australia were used to explore their cognitions about, and underlying motivation for, drink driving as well as the factors that might facilitate or impede it. Although a number of themes were identified, this paper will focus on the first theme, respondents’ self-perceived rationale for their behaviour. Two subthemes were identified: ‘being the hero’ referred to situations where respondents were motivated by a bravado mentality to drive after drinking despite having, on some occasions, the opportunity to avoid this (e.g. another person offering to drive); and ‘family obligations’ which referred to situations where respondents described pressure from members of their extended families to drive after drinking. The underlying responsibility for transporting family members appeared to be difficult to avoid and related to cultural values. Findings indicate the social and individual characteristics for younger drink drivers are similar to mainstream populations. However, the reinforcers for Indigenous drink drivers may be different for this population, consistent with findings on other Indigenous populations outside Australia. Specific programs should contain a family-centred approach and explore the kinship value system to build strategies around these strong relationships.

Local development planning and community empowerment in decentralised Indonesia : the role of local planning in improving self organising capabilities of local communities in Takalar, Indonesia

This study investigates the role of development planning in empowering rural communities in Indonesia’s decentralised era. Evidence is produced that the combination of procedural justice in planning development and social learning in its implementation can assist self-organisation and help empower local communities. Significant benefits are shown to result in: the acquisition and use of collective resources; the development of shared knowledge, skills, values and trust; community leadership; and the development of social networks. Two features of this empowerment model are community-based planning, utilising participatory rural appraisal at the level of the natural village, and the organisation of collective action. These are shown to be effective ways of incorporating procedural justice and social learning in self organisation and community empowerment.

Mapping local solutions to entrenched transport problems: Key lessons regarding the use of geographical information technologies in community mapping with disadvantaged communities

There is an increasing interest in the use of information technology as a participatory planning tool, particularly the use of geographical information technologies to support collaborative activities such as community mapping. However, despite their promise, the introduction of such technologies does not necessarily promote better participation nor improve collaboration. In part this can be attributed to a tendency for planners to focus on the technical considerations associated with these technologies at the expense of broader participation considerations. In this paper we draw on the experiences of a community mapping project with disadvantaged communities in suburban Australia to highlight the importance of selecting tools and techniques which support and enhance participatory planning. This community mapping project, designed to identify and document community-generated transport issues and solutions, had originally intended to use cadastral maps extracted from the government’s digital cadastral database as the foundation for its community mapping approach. It was quickly discovered that the local residents found the cadastral maps confusing as the maps lacked sufficient detail to orient them to their suburb (the study area). In response to these concerns and consistent with the project’s participatory framework, a conceptual base map based on resident’s views of landmarks of local importance was developed to support the community mapping process. Based on this community mapping experience we outline four key lessons learned regarding the process of community mapping and the place of geographical information technologies within this process.

Design LED innovation to rejuvenate local food systems and healthy communities : an emerging research agenda

Food Sovereignty (food freedom) is about empowering people to develop their own local food system. Food Sovereignty challenges designers to enable people to innovate the local food system, rather than having a food system which is dictated by corporate interests and failed business ethics. Communities are realising the potential for design to assist in the innovation process, and add strategic value to potentially localise the food system. Design Led Innovation (DLI) offers a strategic framework to address large-scale cultural, systemic and economic changes. The DLI approach empowers communities to take organised action to achieve a healthy, prosperous and happy way of life. DLI can assist with business models in the business world and it is evident this approach can assist with creating social change too. This paper presents on an emerging research agenda aimed to assist designer’s focus from individuals and systems to communities and urban problems. This paper also presents the research proposition that DLI and service design coupled with social entrepreneurial ventures such as local food projects and creative community inventions, have the potential to enable social innovation for healthy and happy communities.

Shifting from asset dominant to service centric delivery systems: engaging users and communities

Research and practice has observed a shift toward service-oriented approaches that depend on input from users and community as co-producers of services. Yet, in delivering public infrastructure the focus is still on assets rather than services. The contribution of external stakeholders in the co-production of public services is still limited. Using the Policy Delphi with a panel of experts, we found that although practitioners understand the need for asset management to follow the service approach, guidelines and policies still lack that service-centric perspective. Findings revealed a range of obstacles to effective service delivery, related to the sub-optimal involvement of stakeholders’, asymmetric levels of power, the lack of accountability, transparency and availability of government, and the lack of genuine consultations between government and stakeholder groups. The paper concludes by offering directions and strategies for asset managers and policymakers to support and reconnect disengaged government-citizen relations for optimal service delivery outcomes in asset management.

Communication models of institutional online communities : the role of the ABC cultural intermediary

The co-creation of cultural artefacts has been democratised given the recent technological affordances of information and communication technologies. Web 2.0 technologies have enabled greater possibilities of citizen inclusion within the media conversations of their nations. For example, the Australian audience has more opportunities to collaboratively produce and tell their story to a broader audience via the public service media (PSM) facilitated platforms of the Australian Broadcasting Corporation (ABC). However, providing open collaborative production for the audience gives rise to the problem, how might the PSM manage the interests of all the stakeholders and align those interests with its legislated Charter? This paper considers this problem through the ABC’s user-created content participatory platform, ABC Pool and highlights the cultural intermediary as the role responsible for managing these tensions. This paper also suggests cultural intermediation is a useful framework for other media organisations engaging in co-creative activities with their audiences.

Communication models of institutional online communities : the role of the ABC cultural intermediary

The co-creation of cultural artefacts has been democratised given the recent technological affordances of information and communication technologies. Web 2.0 technologies have enabled greater possibilities of citizen inclusion within the media conversations of their nations. For example, the Australian audience has more opportunities to collaboratively produce and tell their story to a broader audience via the public service media (PSM) facilitated platforms of the Australian Broadcasting Corporation (ABC). However, providing open collaborative production for the audience gives rise to the problem, how might the PSM manage the interests of all the stakeholders and align those interests with its legislated Charter? This paper considers this problem through the ABC’s user-created content participatory platform, ABC Pool and highlights the cultural intermediary as the role responsible for managing these tensions. This paper also suggests cultural intermediation is a useful framework for other media organisations engaging in co-creative activities with their audiences.

Review: "Health service frameworks for small rural and remote communities: issues and options" by J. Humphreys, S. Mathews-Cowey, F. Rolley 1996

This monograph is a welcome investigation of current issues in rural health service delivery in smaller communities. The underlying assumption is that existing health service frameworks for rural and remote communities with populations of less than 230 are simply- not appropriate for their needs. With this in mind, the authors identify the strengths and weaknesses of frameworks presently utilised, and offer viable alternatives. They have made information accessible to those who wish to improve the delivery of rural health care, and have provided a catalyst for further research and dialogue on rural health issues...

Successful application of a simple specimen transport method for the conduct of respiratory virus surveillance in remote Indigenous communities in Australia

Objective Surveillance programs and research for acute respiratory infections in remote Aboriginal communities are complicated by difficulties in the storage and transport of frozen samples to urban laboratories for testing. This study assessed the sensitivity of a simple method for transporting respiratory samples from a remote setting for viral PCR compared with frozen specimens. Methods We sampled every individual who presented to a remote Aboriginal community clinic in a non-epidemic respiratory season. Two anterior nasal swabs were collected from each participant. The left nare specimen was mailed to the laboratory via routine postal services. The right nare specimen was transported frozen. Testing for 16 viruses was undertaken using real-time multiplex PCR. Results A total of 140 participants were enrolled who contributed 150 study visits. Respiratory illnesses accounted for 10% of the reasons for presentation. Sixty-one viruses were identified in 50 (33.3%) presentations for 40 (28.6%) individuals; bocavirus and rhinovirus were the most common viruses identified (14.0% and 12.6% of episodes respectively). The sensitivity for any virus detected in mailed specimens was 67.2% (95%CI 55.4, 78.9) compared to 65.6% (95%CI 53.7, 77.5) for frozen specimens. Conclusion The mailing of unfrozen nasal specimens from remote communities does not compromise the viability of the specimen for viral studies.

Building Healthy Communities : GP Network, Medicare Local and Primary Health Care in the Wheatbelt Region of Western Australia

• Government reports consistently recognise the importance of Primary Health Care to an efficient health system. Barriers identified in Australia’s Primary Health Care include workforce pressures, increase rate of chronic disease, and equitable access to Primary Health Care services. • General Practitioners (GPs) are the key to the successful delivery of Primary Health Care especially in rural and remote regions such as the Wheatbelt region in Western Australia (WA). • The Wheatbelt region of WA is vast: some 72,500 residents spread across 150,000km2 in 43 Local Government Authorities catchments. Majority of the Wheatbelt residents live in small towns. There is a higher reported rates of chronic disease, more at risk of chronic diseases and less utilisation of Primary Health Care services in this region. • General practice patients in the Wheatbelt are among those most in need of Primary Health Care services. • Wheatbelt GP Network (the “Network”) was established in 1998. It is a key health service delivery stakeholder in the Wheatbelt. • The Network has responded to the health needs of the community by creating a mobile Allied Health Team that works closely with GPs and is adaptive to ensure priority needs are met. • The Medicare Local model introduced by the Australian Government in 2011 aimed to improve the delivery of Primary Health Care services by improved health planning and coordinating service delivery. • Little if any recognition has been given to the outstanding work that many Divisions of General Practice have done in improving the delivery of Primary Health Care services such as the Network. • The Network has continued to support GPs and general practices and created a complementary system that integrated general practice with the work of an Allied Health Team. Its program mix is extensive. • The Network has consistently delivered on-required contract outputs and has a fifteen (15) years history of operating successfully in a large geographical area comprising in the main smaller communities that cannot support the traditional health services model. • The complexity of supporting International Medical Graduates in the region requires special attention. • The introduction of the Medicare Local in the South West of WA and their intention to take over the delivery of health services, thus effectively shutting the Network will have catastrophic consequences and cannot be supported economically. • The Network proposes to create a new model, built on its past work that increases the delivery of Primary Health Care services through its current Allied Health Team. • The proposal uses the Wheatbelt GP Super Clinic currently under construction in Northam, part of the Network and funded by the Australian Government is a key to the proposed new model. • Wheatbelt GP Super Clinic is different from existing models of GP Super Clinics around Australia which focus predominately on co-location of services. Wheatbelt GP Super Clinic utilises a hub and spoke model of service outreach to small rural towns to ensure equitable Primary Health Care coverage and continuum of care in a financially responsible and viable manner. In particular, the Wheatbelt GP Super Clinic recognises the importance of Allied Health Professionals and will involve them in a collaborative model with rural general practice. • The proposed model advocated by the Network aims to substitute the South West WA Medicare Local direct service delivery proposed for the Wheatbelt. The Network’s proposed model is to expand on the current hub and spoke model of Primary Health Care delivery to otherwise small unviable Wheatbelt towns. A flexible and adaptive skill mix of Allied Health Professionals, Nurse Practitioners and GPs ensure equitable access to service. Expanded scope of practices are utilised to reduce duplication of service and concentration of services in major towns. This involves a partnership approach. • If the proposed model not funded, the Network and the Wheatbelt region will stand to lose 16 Allied Health Professionals and defeats the purpose of Australian Government current funding for the construction of the Wheatbelt GP Super Clinic. • The Network has considered how its model can best be funded. It proposes a re-allocation of funds made available to the South West WA Medicare Local. • This submission argues that the proposal for the South West WA Medicare Local to take over the service delivery of Primary Health Care services in the Wheatbelt makes no economic sense when an existing agency (the Network) has the infrastructure in place, is experienced in working in this geographical area that has special needs and is capable to expand its programs to meet demand.

Learning about being effective mentors : professional learning communities and mentoring

This study aimed to explore experienced mentors’ understandings about professional learning communities (PLCs), mentoring and leadership. This research analyses audio-taped transcripts and written responses from 27 experienced mentors who operate in varied roles (e.g., university academics, school executives, teachers, learning support personnel). Findings indicated that PLCs can provide professional renewal for existing teachers and that mentoring within PLCs can further advance knowledge about effective practices. PLCs can include other staff members and key stakeholders (e.g., preservice teachers, teacher aides) who can contribute to the learning within the group. Mentoring and PLCs can be cost-effective strategic levers for advancing professional knowledge.

Commentary on Nutrition and older Indigenous Australians : service delivery implications in remote communities. A narrative review

Indigenous Australians are the most socially and economically disadvantaged population group in Australia and have the poorest health status. The statistics describe and highlight the degree of sicknesses and disadvantage along with lower life expectancy, elevated mortality rate and increased risk of cardiovascular disease, cancer, diabetes, respiratory disease and kidney disease. While these statistics reflect poor health status and a high level of illness within Indigenous communities, it is known that individual, family and community behaviours play a key role in Indigenous health and wellbeing outcomes. These behavioural issues include use of tobacco, alcohol and other substances along with lack of physical activity and poor nutrition. The paper Nutrition and older Indigenous Australians: Service delivery implications in remote communities. A narrative view explores some of the issues specific to nutrition. Bronwyn Fredericks was invited to provide this commentary by the Editor of the Australasian Journal on Aging.

Labour attraction and retention in rural and remote Queensland communities

Attracting and retaining a skilled labour force is a critical yet complex issue for rural and remote communities. This article reports the findings of a study investigating the current approaches to attraction and retention in two separate Australian regions. Building on previously developed models, this research analyses the roles employers and wider communities are playing, or potentially could play, in addressing issues that influence labour shortages. The findings of this research highlight the complexities of labour attraction and retention and emphasise the need for communities and businesses to work together to overcome labour shortages in rural and remote locations.