Aryati Yashadhana

UNSW Sydney | UNSW · Centre for Primary Health Care and Equity

Introduction Our study aimed to identify factors that influence access to eye care and eye health outcomes for remote Indigenous Australians living with diabetes. Methods In collaboration with Indigenous Community-Based Researchers (CBR) and Aboriginal Community Controlled Health Services (ACCHS), a qualitative, participatory action research appro...

Objectives To describe research into non‐clinical support eye health care for Aboriginal and Torres Strait Islander (Indigenous) Australians, the people who provide such care, and its impact on eye health outcomes. Study design Systematic review and qualitative analysis of peer‐reviewed research publications. Data sources Peer‐reviewed research a...

The prevalence of diabetes among Aboriginal and Torres Strait Islander (hereafter ‘Aboriginal’) Australians is three times greater than non-Aboriginal Australians, contributing to a greater risk of blindness from treatable and preventable ocular conditions, most prominently cataract and diabetic retinopathy. In rural and remote Aboriginal communiti...

This study aims to review articles reporting the perspectives and experiences of pandemic-related discrimination among racially minoritized peoples in high-income contexts. We searched online databases (Medline, EMBASE, PsycINFO, Web of Science, and ProQuest) for peer-reviewed articles published between January 2002 and October 2020. Eligible studi...

Issue Addressed Adolescent e‐cigarette use is increasing and is associated with subsequent smoking. This study examines potential protective factors associated with not vaping among First Nations adolescents in Australia to inform community programs. Methods The ‘ Next Generation: Youth Wellbeing Study’ is a cohort study of First Nations adolescen...

Background Culture and its practice is a recognised, but not well understood factor, in Aboriginal health and wellbeing. Our study aimed to explore how health and wellbeing are phenomenologically connected to cultural practices, foods, medicines, languages, and Country, through the platform of ‘on-Country’ camps facilitated by Aboriginal cultural k...

Background Aboriginal and Torres Strait Islander peoples’ have sustained their cultural practices for over 60,000 years which fundamentally impacts their health and wellbeing. Recent literature emphasizes cultural connection as a contributor to good public health, yet the mechanisms through which cultural engagement promotes health and wellbeing re...

Indigenous cultural health is an emerging field of research and reflects the unique connections Indigenous peoples have with their Country, culture, and knowledge systems. This narrative review explores the concept of cultural health focusing on the interplay between culture, health, and wellbeing within settler colonial contexts. The review is mos...

This article is written from the perspectives of a Yuwaalaraay/Gamilaraay cultural knowledge holder and a Yuin Djirringanj cultural knowledge holder from New South Wales, Australia. It explores the concept of cultural health, and the need to shift towards centring culture in every aspect of Aboriginal health and wellbeing. The three elements of cul...

Issue Addressed Little is currently known about the relationships between body composition and the social determinants of health among Aboriginal and Torres Strait Islander youth in Australia, which could help inform policy responses to address health inequities. Methods This study aimed to explore the relationship between various social factors a...

Background: Local governments are the closest level of government to the communities they serve. Traditionally providing roads, rates and garbage services, they are also responsible for policy and regulation, particularly land use planning and community facilities and services that have direct and indirect impacts on (equitable) health and well-bei...

Background Indigenous peoples experience worse eye health compared to non-Indigenous peoples. Service providers and researchers must avoid perpetuating this inequity. To help achieve this, researchers can use the CONSolIDated critERia for strengthening the reporting of health research involving Indigenous peoples (CONSIDER) statement. This study ai...

Background This targeted and comprehensive policy scan examined how different levels of governments in Australia and Canada responded to the financial crisis brought on by the COVID-19 pandemic. We mapped the types of early policy responses addressing financial strain and promoting financial wellbeing. We also examined their equity considerations....

Introduction The health and well-being of Aboriginal Australians is inextricably linked to culture and Country. Our study challenges deficit approaches to health inequities by seeking to examine how cultural connection, practice and resilience among Aboriginal peoples through participation in ‘cultural camps’ held on sites of cultural significance...

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has exacerbated financial strain among populations worldwide. This is concerning, given the link between financial strain and health. There is little evidence to guide action in this area, particularly from a public health perspective. To address this gap, we examined initiatives to add...

Objectives Integrated people-centred eye care has been recommended as a strategic framework for reducing global vision impairment and blindness. The extent to which eye care has integrated with other services has not been widely reported. We aimed to investigate approaches to integrating eye care service delivery with other systems in low resource...

Background Perceived financial security impacts physical, mental, and social health and overall wellbeing at community and population levels. Public health action on this dynamic is even more critical now that the COVID-19 pandemic has exacerbated financial strain and reduced financial wellbeing. Yet, public health literature on this topic is limit...

Objective: Drawing from a broader study exploring how New South Wales community members from racially minoritized backgrounds experienced living through a pandemic, this paper reports specifically on experiences of racism during the COVID-19 pandemic in 2020. Methods: Using an in-depth, qualitative interpretive approach, 11 semi-structured inter...

Vision impairment among children is associated with lower levels of educational attainment. School-based eye health programs have the potential to provide high-quality and cost-effective services that assist in the prevention of blindness and uncorrected vision impairment, particularly in low-resources settings. The aim of this study was to identif...

Introduction: The COVID-19 pandemic has adversely affected the financial well-being of populations globally, escalating concerns about links with health care and overall well-being. Governments and organizations need to act quickly to protect population health relative to exacerbated financial strain. However, limited practice- and policy-relevant...

Physical activity typically decreases during teenage years and has been identified as a health priority by Aboriginal adolescents. We examined associations between physical activity levels and sociodemographic, movement and health variables in the Aboriginal led 'Next Generation: Youth Well-being (NextGen) Study' of Aboriginal people aged 10-24 yea...

There are an estimated 370 million Indigenous peoples living in more than 70 countries. Indigenous populations are defined as the First Peoples occupying countries or regions at times of colonization, with distinct cultural, religious, and social practices that distinguish them from other populations. Indigenous peoples across the globe have deep,...

Background Community engagement has been endorsed as a key strategy to achieving integrated people-centered eye care that enables people and communities to receive a full spectrum of eye care across their life-course. Understanding the ways communities are engaged in eye care, to what degree participation is achieved, and the factors associated wit...

Access to culturally safe health services is a basic human right, however through the lasting effects of colonisation, oppression, and systemic racism, the individual and community health of Indigenous peoples in Australia and Aotearoa New Zealand have been severely impacted. The Aboriginal and Torres Strait Islander Health and Cultural Safety Stra...

This chapter draws on the Aboriginal and Torres Strait Islander experience of the COVID-19 pandemic in Australia, with a focus on the spatial differences in urban and rural health outcomes and responses. We explore cultural, socioeconomic, and place-based dimensions of COVID-19 among Aboriginal peoples including inequity around transmission, infect...

Background: Rapid, strategic action is required to mitigate the negative and unequal impact of the coronavirus disease 2019 (COVID-19) pandemic on the financial well-being (FWB) of global populations. Personal financial strain (FS) worsened most significantly among systematically excluded groups. Targeted government- and community-led initiatives...

Most research involving Aboriginal and Torres Strait Islander peoples has been conducted by non-Indigenous people and has not been a positive experience for many Aboriginal and Torres Strait Islander communities. This scoping review maps approaches to health research involving Aboriginal and Torres Strait Islander peoples and communities in Austral...

From a ‘lucky country’ on the edge of the world, AustraliaAustralia and its governments felt they had weathered the pandemicPandemic storm in October 2020. But, the insular approach to combatting COVID-19Covid-19 cracked in the months since. A series of critical failures in government responseResponses has been identified. These include vaccine pro...

Background: In northern Australia, Aboriginal and Torres Strait Islander Health Workers (A&TSIHWs) are unique members of nominally integrated teams of primary care professionals. Spurred by research documenting ongoing structural violence experienced by Indigenous health providers and more recent challenges to recruitment and retention of A&TSIHWs...

Healthcare services in Australia are the primary responsibility of state and territory governments, which recruit and deploy health providers in hospital and primary-care services. Among the various health professional roles, that of Aboriginal and Torres Strait Islander Health Worker (A&TSIHW) is one of only two positions that must be occupied by...

Background We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods Drawing on methods used in previou...

Objectives To identify barriers and enablers to accessing school-based eye health programs in Bogotá, Colombia. Methods We undertook a qualitative case study that explored how structural factors, and social and cultural norms influence access to school-based eye health programs. We conducted focus groups discussions and interviews with a purposive...

Objective To identify and describe articles reporting the experiences and perceptions of ageing among older First Nations Australians. Methods Following rapid review and PRISMA guidelines, we searched five databases for peer-reviewed articles published prior to October 2019 that reported qualitative accounts of ageing among older (≥ 45 years) Firs...

If health promotion as a field of change for human and ecological health is to maintain its urgency, it needs to continue building its policy credentials. This paper charts the development of policy as a concern for IUHE/IUHPE (International Union for Health Education/International Union for Health Promotion and Education) from the mid-1970s when ‘...

Purpose People who are distinct from the dominant ethnic group within a country can experience a variety of barriers to accessing eyecare services. We conducted a scoping review to map published interventions aimed at improving access to eyecare for non-Indigenous, non-dominant ethnic groups residing in high-income countries. Methods We searched M...

As the COVID-19 pandemic took hold in 2020, Chief Medical Officers (CMOs) entered the public spotlight like never before. Amidst this increased visibility, the role is deeply contested. Much of the disagreement concerns whether CMOs should act independently of the government: while some argue CMOs should act as independent voices who work to shape...

Aboriginal and Torres Strait Islander Health Workers (A&TSIHWs) are a professional cadre of Australian health workers typically located in primary care clinics. The role is one of only two that is ‘identified’— that is, it must be occupied by an Aboriginal and/or Torres Strait Islander person — and holds specific responsibilities in relation to adv...

Purpose To assess the diversity of leadership bodies of member organisations of the International Council of Ophthalmology (ICO) and the World Council of Optometry (WCO) in terms of: (1) the proportion who are women in all world regions, and (2) the proportion who are ethnic minority women and men in Eurocentric high‐income regions. Methods We und...

Despite the existence of evidence-based recommendations to decrease risk and progression of Age-Related Macular Degeneration (AMD) for some time, self-reported practices suggest that eyecare professionals’ advice and people with AMD’s adherence to these recommendations can be very poor. This study uses qualitative methods to explore Australian eyec...

Problem: In the Katherine region, Northern Territory, barriers to eye care for Aboriginal and Torres Strait Islander people include unclear eye care referral processes, challenges coordinating patient eye care between various providers, complex socioeconomic determinants and a lengthy outpatient ophthalmology waiting list. Design: Mixed methods...

The prevalence of diabetes among Aboriginal and Torres Strait Islander (hereafter ‘Aboriginal’) Australians is three times greater than non-Aboriginal Australians, contributing to a greater risk of blindness from treatable and preventable ocular conditions, most prominently cataract and diabetic retinopathy. Annual retinal screening is recommended...

Despite the existence of evidence-based recommendations to decrease risk and progression of Age-Related Macular Degeneration (AMD) for some time, self-reported practices suggest that eyecare professionals’ advice and people with AMD’s adherence to these recommendations can be very poor. This study uses qualitative methods to explore Australian eyec...

Objective: To review interventions improving eye-care services for schoolchildren in low- and middle-income countries. Methods: We searched online databases (CINAHL, Embase®, ERIC, MEDLINE®, ProQuest, PubMed® and Web of ScienceTM) for articles published between January 2000 and May 2018. Eligible studies evaluated the delivery of school-based ey...

Preventable diseases are the leading cause of illness and mortality for Indigenous Australians, especially those living in remote areas (Vos et al, 2009). The alarming prevalence of diabetes among Indigenous adults (39% >55 years) (ABS, 2013) has raised the risk of diabetic visual impairment. While the availability and continued funding of remote h...

Introduction: A person’s capability to access services and achieve good eye health is influenced by their behaviours, perceptions, beliefs and experiences. As evidence from Papua New Guinea (PNG) about people’s lived experience with vision impairment is limited, the purpose of the present study was to better understand the beliefs, perceptions and...

The alarming prevalence of diabetes among the adult Australian Indigenous population (37% >55 years) (ABS, 2013) has subsequently raised the risk and prevalence of diabetic visual impairment (Taylor, 2009). Issues around prevention and access to care continue to support disparities in health equity between the Indigenous and non-Indigenous populati...

Aboriginal and Torres Strait Islander (herein Indigenous) Australians collectively experience some of the worst health outcomes globally (Gracey & King, 2009). Through the provision of culturally appropriate primary health care, Aboriginal Community Controlled Health Services (ACCHS) deliver a continued contribution to closing the gap in health bet...

Preventable eye diseases cause 94% of vision loss in Aboriginal and Torres Strait Islander (herein Aboriginal) adults (Taylor et al, 2012). Despite this, blindness rates in Aboriginal adults continue to sit at 6 times the rate of the mainstream population (Taylor et al, 2012). Recent studies have identified structural and systemic factors that inhi...

Research is an important part of understanding the complexities of health in equity, and has been identified nationally as crucial in building effective evidence based practice and policy in Aboriginal and Torres Strait Islander (Aboriginal) health. In recent times, approaches to Aboriginal health research have shifted to reflect the role of Aborig...