Platform Presentation The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

Evidence for the use of co-design with Aboriginal and/or Torres Strait Islander People to strengthen cardiovascular health: A scoping review. (#64)

Heidi Janssen 1 2 3 , Md Hasnain 1 4 , Simone Owen 3 , Alex Brown 5 , Reakeeta Smallwood 6 , Kim Usher 7 , Vickie Brandy 8 , Amy Thompson 9 , Neil J Spratt 1 8 10 , Anna Holwell 11 , Susan Hillier 12 , Uncle Neville Sampson 13 , Aunty Audrey Trindall 13 14 , Michelle Kennedy 4 , Joe Miller 14 , Clare Tiedeman 15 , Natalie Ciccone 16 , Andrew Boyle 1 4 8 , Aaron Sverdlov 1 4 8 , Carlos Garcia‐Esperon 1 4 8 , Rachel Peake 17 , Michael Pollack 8 18 , Michael Nilsson 4 , Liz Holliday 4 , Clare Willis 19 , Christopher Levi 1 4 8 , and The Yarning up After Stroke Collaborative Group 20
  1. Heart and Stroke Program , Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
  2. School of Health Sciences, University of Newcastle, Newcastle, NSW, Australia
  3. Hunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
  4. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
  5. Cardiometabolic Disease Research Program, South Australian Medical Research Institute , Adelaide, SA, Australia
  6. Newcastle’s Department of Rural Health, University of Newcastle, Tamworth, NSW, Australia
  7. School of Health, University of New England, Armidale, NSW, Australia
  8. Hunter New England Health Local Health District, New Lambton Heights, NSW, Australia
  9. Consumer with lived experience, Kempsey, NSW, Australia
  10. School of Biomedical Sciences and Pharmacy, University of Newcastle , Newcastle, NSW, Australia
  11. Alice Springs Hospital , Alice Springs, NT, Australia
  12. University of South Australia, Adelaide, SA, Australia
  13. Community Elder, Tamworth, NSW, Australia
  14. Consumer with lived experience , Tamworth, NSW, Australia
  15. John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
  16. School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
  17. Hunter New England Local Health District, Tamworth, NSW, Australia
  18. Centre for Rehab Innovations, University of Newcastle, Newcastle, NSW, Australia
  19. The Grey Area, Sydney, NSW, Australia
  20. Cardiovascular Health Mission, Medical Research Future Fund, Australia

.

Background: Developing culturally safe and effective strategies to strengthen the cardiovascular health of Aboriginal and/or Torres Strait Islander* Peoples is achieved through culturally appropriate and evidenced-based co-design. The co-design must have Aboriginal leadership, inclusive partnerships, methods grounded in cultural and respectful ways and be of benefit to Aboriginal communities.

 

Aims: To summarise and describe the evidence of (i) the use of culturally appropriate co-design and (ii) strategies shown to be effective when working with Aboriginal communities to prevent or support recovery following a cardiovascular event.

 

Methods: Aboriginal researchers and community members with expertise in public, cardio-cerebrovascular and community health and rehabilitation medicine were joined by non-Aboriginal researchers in all study processes. Five electronic databases (CINAHL, PsycINFO, EMBASE, MEDLINE and Web of Science) were searched (March 2022) using a search strategy checked and finalised by an expert librarian. Included studies (i) utilised culturally appropriate co-design and (ii) evaluated the effect of strategies to either prevent primary/secondary cardiovascular events, or support recovery from same.  

 

Results: Title screening (n=2652) resulted in 551 full text reviews where 5 studies met inclusion criteria and reported results from strategies applied in cardiac rehabilitation (n=2), and for managing diabetes (n=2) and weight loss (n=1). All applied participatory action research methods including engagement with Community Elders/members and Aboriginal Medical Services. There were reported significant improvements in cardiovascular health outcomes. Certainty around these results for all but one study (n=575) was limited by small sample sizes and/or absence of a control group.   

 

Conclusion: Emerging evidence of the benefits gained when Aboriginal communities and researchers work together in the development and testing of strategies to strengthen cardiovascular health highlights the need for larger community-led studies. The Yarning up After Stroke Collaborative Group is applying learnings from this study and led by Aboriginal communities on Gamilaroi Country will develop culturally safe stroke recovery tools which incorporate yarning.