What explains the association between socioeconomic status and depression among Vietnamese adults?

Background Depression is a major public health problem worldwide and is currently ranked second to heart disease for years lost due to disability. For many decades, international research has found that depressive symptoms occur more frequently among low socioeconomic (SES) individuals than their more-advantaged peers. However, the reasons as to why those of low socioeconomic groups suffer more depressive symptoms are not well understood. Studies investigating the prevalence of depression and its association with SES emanate largely from developed countries, with little research among developing countries. In particular, there is a serious dearth of research on depression and no investigation of its association with SES in Vietnam. The aims of the research presented in this Thesis are to: estimate the prevalence of depressive symptoms among Vietnamese adults, examine the nature and extent of the association between SES and depression and to elucidate causal pathways linking SES to depressive symptoms Methods The research was conducted between September 2008 and November 2009 in Hue city in central Vietnam and used a combination of qualitative (in-depth interviews) and quantitative (survey) data collection methods. The qualitative study contributed to the development of the theoretical model and to the refinement of culturally-appropriate data collection instruments for the quantitative study. The main survey comprised a cross-sectional population–based survey with randomised cluster sampling. A sample of 1976 respondents aged between 25-55 years from ten randomly-selected residential zones (quarters) of Hue city completed the questionnaire (response rate 95.5%). Measures SES was classified using three indicators: education, occupation and income. The Center for Epidemiologic Studies-Depression (CES-D) scale was used to measure depressive symptoms (range0-51, mean=11.0, SD=8.5). Three cut-off points for the CES-D scores were applied: ‘at risk for clinical depression’ (16 or above), ‘depressive symptoms’ (above 21) and ‘depression’ (above 25). Six psychosocial indicators: life time trauma, chronic stress, recent life events, social support, self esteem, and mastery were hypothesized to mediate the association between SES and depressive symptoms. Analyses The prevalence of depressive symptoms were analysed using bivariate analyses. The multivariable analytic phase comprised of ordinary least squares regression, in accordance with Baron and Kenny’s three-step framework for mediation modeling. All analyses were adjusted for a range of confounders, including age, marital status, smoking, drinking and chronic diseases and the mediation models were stratified by gender. Results Among these Vietnamese adults, 24.3% were at or above the cut-off for being ‘at risk for clinical depression’, 11.9% were classified as having depressive symptoms and 6.8% were categorised as having depression. SES was inversely related to depressive symptoms: the least educated those with low occupational status or with the lowest incomes reported more depressive symptoms. Socioeconomicallydisadvantaged individuals were more likely to report experiencing stress (life time trauma, chronic stress or recent life events), perceived less social support and reported fewer personal resources (self esteem and mastery) than their moreadvantaged counterparts. These psychosocial resources were all significantly associated with depressive symptoms independent of SES. Each psychosocial factor showed a significant mediating effect on the association between SES and depressive symptoms. This was found for all measures of SES, and for males and females. In particular, personal resources (mastery, self esteem) and chronic stress accounted for a substantial proportion of the variation in depressive symptoms between socioeconomic groups. Social support and recent life events contributed modestly to socioeconomic differences in depressive symptoms, whereas lifetime trauma contributed the least to these inequalities. Conclusion This is the first known study in Vietnam or any developing country to systematically examine the extent to which psychosocial factors mediate the relationship between SES and depression. The study contributes new evidence regarding the burden of depression in Vietnam. The findings have practical relevance for advocacy, for mental health promotion and health-care services, and point to the need for programs that focus on building a sense of personal mastery and self esteem. More broadly, the work presented in this Thesis contributes to the international scientific literature on the social determinants of depression.

Shattered dreams : a community project

The research field was community empowerment through education and skill-building. The context was the high rates of domestic violence in the Aboriginal and Torres Strait Islander community, and the dearth of culturally-appropriate resource materials to stimulate and encourage community engagement with the issue. The research question concerned the use of a specific media project – the creation of a 7-minute 48-second DVD on the causes and impacts of domestic violence – as a focus for community empowerment, education and skills development. The research represented an innovative partnership between the university research team, a non-government organisation, and various expert content-providers. The project generated new knowledge regarding best practice, in such areas as the culturally appropriate use of the voices of elders, focusing on the responsibilities of both men and women in relation to family and domestic violence, and the protection of Aboriginal and Islander children. The project has created an excellent tool for workshops on related issues including familiarity with the legal system. The film has been distributed to Aboriginal and Torres Strait Islander domestic violence services throughout the State, and has generated interstate interest, indicating a significant gap in available culturally-appropriate domestic violence resources. A support package for educational workers within Indigenous community groups wishing to use the resource has also been produced. In 2010, the DVD was nominated for a Queensland Domestic and Family Violence Prevention Award. Other non-government organisations have expressed interest in using the model created through this community-based project.

Relationships and sexual health promotion project for QUT international students

International students may experience a variety of sexual health problems which include unplanned pregnancies, abortions and sexually transmitted diseases. These are often because of limited knowledge of sexual health matters and lack of sexual health education and/or access to health services in their home country. A study was undertaken to identify the concerns of international students and how to provide culturally appropriate promotion of sexual health for international students at Queensland University of Technology (QUT). The project included consultations with stakeholders, interviews with key informants, an online survey and focus group discussions with international students. The project found that sexual health is a concern for international students, particularly in developing relationships and when becoming sexually active in Australia, and there is a perceived lack of access to health services and insufficient knowledge on sexual health matters. Preferred methods of dissemination of sexual health information included use of student mentors, web-based online resources, brochures and confidential on-line advice.

Food insecurity among adults residing in disadvantaged urban areas : potential health and dietary consequences

Objective: Food insecurity is the limited or uncertain availability or access to nutritionally-adequate, culturally-appropriate and safe foods. Food insecurity may result in inadequate dietary intakes, overweight or obesity and the development of chronic disease. Internationally, few studies have focused on the range of potential health outcomes related to food insecurity among adults residing in disadvantaged locations and no such Australian studies exist. The objective of this study was to investigate associations between food insecurity, socio-demographic and health factors and dietary intakes among adults residing in disadvantaged urban areas. Design: Data were collected by mail survey (n= 505, 53% response rate), which ascertained information about food security status, demographic characteristics (such as age, gender, household income, education) fruit and vegetable intakes, take-away and meat consumption, general health, depression and chronic disease. Setting: Disadvantaged suburbs of Brisbane city, Australia, 2009. Subjects: Individuals aged ≥ 20 years. Results: Approximately one-in-four households (25%) were food insecure. Food insecurity was associated with lower household income, poorer general health, increased healthcare utilisation and depression. These associations remained after adjustment for age, gender and household income. Conclusion: Food insecurity is prevalent in urbanised disadvantaged areas in developed countries such as Australia. Low-income households are at high risk of experiencing food insecurity. Food insecurity may result in significant health burdens among the population, and this may be concentrated in socioeconomically-disadvantaged suburbs.

Smoking status as a moderator of the association between food insecurity and decreased fruit and vegetable consumption

Food insecurity is the inadequate access to, or availability of, sufficient amounts of nutritious, culturally-appropriate and safe foods, or the inability to acquire such foods by socially acceptable means. Food insecurity has been shown to be associated with poor dietary intakes and poor health status. Recently, evidence has emerged suggesting increased rates of food insecurity among those with substance abuse problems, including those who smoke. This cross-sectional study investigates the potential moderating effect of smoking on the association between food insecurity and fruit and vegetable intakes among the Australian population, using regression analyses. Participants were adults 18 years and older participating in the 2004/05 National Health Survey (n = 19,500). Those from food insecure households were up to two-times more likely to report inadequate fruit and vegetable intakes compared to those who were food secure. Those who smoked were nearly six times more likely to report being food insecure, and up to three-times more likely to report inadequate fruit and vegetable intakes, compared to their non-smoking counterparts. Further analyses revealed a marked decline in the strength of the association between food insecurity and fruit consumption with the addition of smoking status into a regression model. These findings have important implications for the development of policy and interventions to address food insecurity, suggesting that those from food insecure households are less likely to comply with national dietary recommendations, and that this may in part be moderated by smoking status.

Associations exist between food insecurity, poor diet, chronic illness and obesity among an Australian population

Food insecurity is the limited availability of, or access to, sufficient amounts of nutritious, culturally-appropriate and safe foods, or the inability to access such foods by socially-acceptable means. Evidence from the United States and Canada suggests that food insecurity may be associated with poor dietary intakes, obesity, and chronic disease including depression and diabetes, thus constituting a significant public health issue. Currently, no existing studies have investigated the dietary and health factors associated with food insecurity among the general Australian population. The current study investigated the potential associations between food insecurity, diet and health among Australian adults (18 years and over) participating in the cross-sectional National Health Survey (n = 19,500). Data were analysed by logistic regression adjusting for sociodemographic covariates. Those from food insecure households were 50% less likely to consume the recommended number of servings of fruit, 60% more likely to report poor health and experienced a 6-fold increase in the risk of severe depressive disorders, compared to their food secure counterparts. Furthermore, food insecurity was associated with a 50% increase in the risk of being diagnosed with ‘high sugar levels’. Finally, women from food insecure households were 30% more likely to be obese compared to their food secure counterparts. These findings suggest that food insecurity may play an important role in preventing adherence with national dietary recommendations, and may increase the risk of obesity and chronic illness. This has important implications for both clinical practice, and the development of interventions and policy to address food insecurity.

Assessing food insecurity : current underestimations in Australia, alternative measures and reflections on their use

Food insecurity is the limited access to, or availability of, nutritious, culturally-appropriate and safe foods, or the inability to access these foods by socially acceptable means. In Australia, the monitoring of food insecurity is limited to the use of a single item, included in the three-yearly National Health Survey (NHS). The current research comprised a) a review of the literature and available tools to measure food security, b) piloting and adaptation of the more comprehensive 16-item United States Department of Agriculture (USDA) Food Security Survey Module (FSSM), and c) a cross-sectional study comparing this more comprehensive tool, and it’s 10- and 6- item short forms, with the current single-item used in the NHS, among a sample of households in disadvantaged urban-areas of Brisbane, Australia. Findings have shown that internationally the 16-item USDA-FSSM is the most widely used tool for the measurement of food insecurity. Furthermore, of the validated tools that exist to measure food insecurity, sensitivity and reliability decline as the number of questions in a tool decreases. Among an Australian sample, the current single-measure utilised in the NHS yielded a significantly lower prevalence for food insecurity compared to the 16-item USDA-FSSM and it’s two shorter forms respectively (four and two percentage points lower respectively). These findings suggest that the current prevalence of food insecurity (estimated at 6% in the most recent NHS) may have been underestimated, and have important implications for the development of an effective means of monitoring food security within the context of a developed country.

What are the implications of peri-urban agriculture on food security in Australian cities?

Background: Periurban agriculture refers to agricultural practice occurring in areas with mixed rural and urban features. It is responsible 25% of the total gross value of economic production in Australia, despite only comprising 3% of the land used for agriculture. As populations grows and cities expand, they are constantly absorbing surrounding fringe areas, thus creating a new fringe, further from the city causing the periurban region to constantly shift outwards. Periurban regions are fundamental in the provision of fresh food to city populations and residential (and industrial) expansion taking over agricultural land has been noted as a major worldwide concern. Another major concern around the increase in urbanisation and resultant decrease in periurban agriculture is its potential effect on food security. Food security is the availability or access to nutritionally-adequate, culturally-relevant and safe foods in culturally-appropriate ways. Thus food insecurity occurs when access to or availability of these foods is compromised. There is an important level of connectedness between food security and food production and a decrease in periurban agriculture may have adverse effects on food security. A decrease in local, seasonal produce may result in a decrease in the availability of products and an increase in cost, as food must travel greater distances, incurring extra costs present at the consumer level. Currently, few Australian studies exist examining the change in periurban agriculture over time. Such information may prove useful for future health policy and interventions as well as infrastructure planning. The aim of this study is to investigate changes in periurban agriculture among capital cities of Australia. Methods: We compared data pertaining to selected commodities from the Australian Bureau of Statistics 2000-01 and 2005 -2006 Agricultural Census. This survey is distributed online or via mail on a five-yearly basis to approximately 175,000 Agricultural business to ascertain information on a range of factors, such as types of crops, livestock and land preparation practices. For the purpose of this study we compared the land being used for total crops, and cereal , oil seed, legume, fruit and vegetable crops separately. Data was analysed using repeated measures anova in spss. Results: Overall, total area available for crops in urbanised areas of Australia increased slightly by 1.8%. However, Sydney, Melbourne, Adelaide and Perth experienced decreases in the area available for fruit crops by 11%, 5%,and 4% respectively. Furthermore, Brisbane and Perth experienced decreases in land available for vegetable crops by 28% and 14% respectively. Finally, Sydney, Adelaide and Perth experienced decreases in land available for cereal crops by 10 – 79%. Conclusions: These findings suggest that population increases and consequent urban sprawl may be resulting in a decrease in peri-urban agriculture, specifically for several core food groups including fruit, breads and grain based foods. In doing so, access to or availability of these foods may be limited, and the cost of these foods is likely to increase, which may compromise food insecurity for certain sub-groups of the population.

Weaving the past into the present : Indigenous stories of education across generations

In Queensland, there is little research that speaks to the historical experiences of schooling. Aboriginal education remains a part of the silenced history of Aboriginal people. This thesis presents stories of schooling from Aboriginal people across three generations of adult storytellers. Elders, grandparents, and young parents involved in an early childhood urban playgroup were included. Stories from the children attending the playgroup were also welcomed. The research methodology involved narrative storywork. This is culturally appropriate because Aboriginal stories connect the past with the present. The conceptual framework for the research draws on decolonising theory. Typically, reports of Aboriginal schooling and outcomes position Aboriginal families and children within a deficit discourse. The issues and challenges faced by urban Murri families who have young children or children in school are largely unknown. This research allowed Aboriginal families to participate in an engaged dialogue about their childhood and offered opportunities to tell their stories of education. Key research questions were: What was the reality of school for different generations of Indigenous people? What beliefs and values are held about mainstream education for Indigenous children? What ideas are communicated about school across generations? Narratives from five elders, five grandparents, and five (urban) mothers of young Indigenous children are presented. The elders offer testimony on their recollected experiences of schooling in a mission, a Yumba school (fringe-dwellers’ camp), and country schools. Their stories also speak to the need to pass as non-indigenous and act as “white”. The next generation of storytellers are the grandparents and they speak to their lives as “stolen children”. The final story tellers are the Murri parents. They speak to the current and recent past of education, as well as their family experiences as they parent young children who are about to enter school or who are in the early years of school.

Validating a screening tool for mental health and substance use risk in an Indigenous prison population

Introduction and Aims: The Indigenous Risk Impact Screen (IRIS) is a validated culturally appropriate and widely used tool in the community for assessing substance use and mental disorder. This research aimed to assess the utility of this tool in an Indigenous prison population. Design and Methods: The study used data collected from a cross-sectional study of mental health among indigenous inmates in Queensland custodial centres (n=395, 84% male). Participants were administered a modified version of the IRIS, and ICD-10 diagnoses of substance use, depressive and anxiety disorders obtained using the Composite International Diagnostic Interview (CIDI). The concurrent validity of the modified IRIS was assessed against those of the CIDI. Results: 312 people screened as high risk for a substance use disorder and 179 were high risk for mental problems. 73% of males and 88% of females were diagnosed with a mental disorder. The IRIS was an effective screener for substance use disorders, with high sensitivity (Se) of 94% and low specificity (Sp) of 33%. The screener was less effective in identifying depression (Se 82%, Sp 59%) and anxiety (Se 68%, Sp 60%). Discussion: The IRIS is the first culturally appropriate screening instrument to be validated for the risk of drug and alcohol and mental disorder among Indigenous adults in custody. Conclusions: This study demonstrated that the IRIS is a valid tool for screening of alcohol and drug use risk among an incarcerated Indigenous population. The IRIS could offer an opportunity to improve the identification, treatment and health outcomes for incarcerated Indigenous adults.

Culture in and culture of health promotion: tensions at the interface of Australian Indigenous health promotion

With persisting health inequalities across and between diverse populations, health promotion must consider its engagement with the culture concept in achieving better health for all. By way of a conversation between an Indigenous and non-Indigenous health promotion practitioner, this unique presentation will critically examine the cultural practice of health promotion for Indigenous Australians. Culture becomes the central tenant of this conversation – but not culture in the sense of something to “fix” to improve Indigenous health, or import to make mainstream practices “culturally appropriate”. Rather, the somewhat invisible culture of Australian health promotion practice itself is highlighted. The enthusiasm of mainstream health promotion practice for risk and reductionism supplants biological determinism with a cultural determinism that constructs culture as illness-producing. This is in contrast to Indigenous perspectives of culture in which it is described as integral to individual and community health and well-being. Whilst empowerment features strongly within global health promotion discourses, the preoccupation of health promotion with the inherent deficit/behavioural change approach is an all too convenient distraction from the broader structural factors impacting on the health of Indigenous Australians. That Indigenous Australians have not benefitted from successful public health policy interventions in the same way as the general population is in itself revealing of the culture of health promotion practice in Australia and it is somewhat ironic that the health promotion fraternity seems not to have questioned its own practice. This conversation aims to encourage health promotion practitioners, researchers and policy makers to interrogate the cultural assumptions of their own practice and of the public health system they are part of and consider how to embed and empower the voices and experiences of those who are ‘culturally othered’ within health promotion practice.

Food and Brisbane households : dietary, social and health consequences of food insecurity

Background & Aims: Access to sufficient amounts of safe and culturally-acceptable foods is a fundamental human right. Food security exists when all people, at all times, have physical, social, and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life. Food insecurity therefore occurs when the availability or access to sufficient amounts of nutritionally-adequate, culturally-appropriate and safe foods, or, the ability to acquire such foods in socially-acceptable ways, is limited. Food insecurity may result in significant adverse effects for the individual and these outcomes may vary between adults and children. Among adults, food insecurity may be associated with overweight or obesity, poorer self-rated general health, depression, increased health-care utilisation and dietary intakes less consistent with national recommendations. Among children, food insecurity may result in poorer self or parent-reported general health, behavioural problems, lower levels of academic achievement and poor social outcomes. The majority of research investigating the potential correlates of food insecurity has been undertaken in the United States (US), where regular national screening for food insecurity is undertaken using a comprehensive multi-item measurement. In Australia, screening for food insecurity takes place on a three yearly basis via the use of a crude, single-item included in the National Health Survey (NHS). This measure has been shown to underestimate the prevalence of food insecurity by 5%. From 1995 – 2004, the prevalence of food insecurity among the Australian population remained stable at 5%. Due to the perceived low prevalence of this issue, screening for food insecurity was not undertaken in the most recent NHS. Furthermore, there are few Australian studies investigating the potential determinants of food insecurity and none investigating potential outcomes among adults and children. This study aimed to examine these issues by a) investigating the prevalence of food insecurity among households residing in disadvantaged urban areas and comparing prevalence rates estimated by the more comprehensive 18-item and 6-item United States Department of Agriculture (USDA) Food Security Survey Module (FSSM) to those estimated by the current single-item measure used for surveillance in Australia and b) investigating the potential determinants and outcomes of food insecurity, Methods: A comprehensive literature review was undertaken to investigate the potential determinants and consequences of food insecurity among developed countries. This was followed by a cross-sectional study in which 1000 households from the most disadvantaged 5% of Brisbane areas were sampled and data collected via mail-based survey (final response rate = 53%, n = 505). Data were collected for food security status, sociodemographic characteristics (household income, education, age, gender, employment status, housing tenure and living arrangements), fruit and vegetable intakes, meat and take-away consumption, presence of depressive symptoms, presence of chronic disease and body mass index (BMI) among adults. Among children, data pertaining to BMI, parent-reported general health, days away from school and activities and behavioural problems were collected. Rasch analysis was used to investigate the psychometric properties of the 18-, 10- and 6-item adaptations of the USDA-FSSM, and McNemar's test was used to investigate the difference in the prevalence of food insecurity as measured by these three adaptations compared to the current single-item measure used in Australia. Chi square and logistic regression were used to investigate the differences in dietary and health outcomes among adults and health and behavioural outcomes among children. Results were adjusted for equivalised household income and, where necessary, for indigenous status, education and family type. Results: Overall, 25% of households in these urbanised-disadvantaged areas reported experiencing food insecurity; this increased to 34% when only households with children were analysed. The current reliance on a single-item measure to screen for food insecurity may underestimate the true burden among the Australian population, as this measure was shown to significantly underestimate the prevalence of food insecurity by five percentage points. Internationally, major potential determinants of food insecurity included poverty and indicators of poverty, such as low-income, unemployment and lower levels of education. Ethnicity, age, transportation and cooking and financial skills were also found to be potential determinants of food insecurity. Among Australian adults in disadvantaged urban areas, food insecurity was associated with a three-fold increase in experiencing poorer self-rated general health and a two-to-five-fold increase in the risk of depression. Furthermore, adults from food insecure households were twoto- three times more likely to have seen a general practitioner and/or been admitted to hospital within the previous six months, compared to their food secure counterparts. Weight status and intakes of fruits, vegetables and meat were not associated with food insecurity. Among Australian households with children, those in the lowest tertile were over 16 times more likely to experience food insecurity compared to those in the highest tertile for income. After adjustment for equivalised household income, children from food insecure households were three times more likely to have missed days away from school or other activities. Furthermore, children from food insecure households displayed a two-fold increase in atypical emotions and behavioural difficulties. Conclusions: Food insecurity is an important public health issue and may contribute to the burden on the health care system through its associations with depression and increased health care utilisation among adults and behavioural and emotional problems among children. Current efforts to monitor food insecurity in Australia do not occur frequently and use a tool that may underestimate the prevalence of food insecurity. Efforts should be made to improve the regularity of screening for food insecurity via the use of a more accurate screening measure. Most of the current strategies that aim to alleviate food insecurity do not sufficiently address the issue of insufficient financial resources for acquiring food; a factor which is an important determinant of food insecurity. Programs to address this issue should be developed in collaboration with groups at higher risk of developing food insecurity and should incorporate strategies to address the issue of low income as a barrier to food acquisition.

Rebuilding in Ranongga : reflecting on practice based research

Two hundred million people are displaced annually due to natural disasters with a further one billion living in inadequate conditions in urban areas. Architects have a responsibility to respond to this statistic as the effects of natural and social disasters become more visibly catastrophic when paired with population rise. The research discussed in this paper initially questions and considers how digital tools can be employed to enhance rebuilding processes, but still achieve sensitive, culturally appropriate and accepted built solutions. Secondly the paper reflects on the impact ‘real-world’ projects have on architectural education. Research aspirations encouraged an atypical ‘research by design’ methodology involving a focused case study in the recently devastated village Keigold, Ranongga, Solomon Islands. Through this qualitative approach specific place data and the accounts of those affected were documented through naturalistic and archival methods of observation and participation. Findings reveal a number of unanticipated results which would have been otherwise undetected if field research within the design and rebuilding process was not undertaken, reflecting the importance of place specific research in the design process. Ultimately, the study proves that it is critical for issues of disaster to be addressed on a local rather than global scale; decisions cannot be speculative, or solved at a distance, but require intensive collaborative work with communities to achieve optimum solutions. Architectural education and design studios would continue to benefit from focused community engagement and field research within the design process.

Developmental lessons from the Capricornia Arts Mob (CAM)

The Capricornia Arts Mob (CAM) is a collective of Aboriginal and Torres Strait Islander visual artists, sculptors, photographers, carvers and writers based in the Rockhampton region of Central Queensland. This paper explores the early development of CAM, identifies some of the lessons its members have learned about working together, and considers its role as a regional artists’ collective. The authors identify that traditional Indigenous practices, such as yarning and the sharing of food, have helped to facilitate the emergence of CAM as a vibrant, challenging, eclectic artistic family. They recognise the cultural challenges faced by the collective – including finding a culturally appropriate place to meet and work, and the cross-cultural issues that can emerge within Aboriginal and Torres Strait Islander groups. In just 18 months, CAM has held successful exhibitions and developed public artworks. It is a strong part of regional Queensland’s arts scene, which supports emerging artists and provides a space to celebrate and support Indigenous art.

Charting a theoretical framework for examining Indigenous journalism culture

Indigenous media around the globe have expanded considerably in recent years, a process that has also led to an increase in the number of Indigenous news organisations. Yet, research into Indigenous news and journalism is still rare, with mostly individual case studies having been undertaken in different parts of the globe. Drawing on existing research gathered from a variety of global contexts, this paper theorises five main dimensions which can help us think about and empirically examine Indigenous journalism culture. They include: the empowerment role of Indigenous journalism; the ability to offer a counter-narrative to mainstream media reporting; journalism’s role in language revitalisation; reporting through a culturally appropriate framework; and the watchdog function of Indigenous journalism. These dimensions are discussed in some detail, in an attempt to guide future studies into the structures, roles, practices and products of Indigenous journalism across the globe.