or a related mental health disorder: A Wurundjeri community driven initiative. Study findings and recommendations. Melbourne: Heart Research Institute, The.
INDIGENOUS SOCIAL AND EMOTIONAL WELLBEING RESEARCH Figure 1 Consort diagram indicating number of original articles or reports found at each step
Search Results Electronic database search: 2051 Website search: 237 Total: 2288
Excluded on title and abstract From electronic database search: 1307 Electronic duplicates: 402 From website search: 184 Total: 1893
Number of items requiring full text review From electronic database search: 342 From website search: 53 Total: 395
Reviewed and excluded by 2 authors From electronic database search: 313 From website search: 36 Duplicates: 9 Total: 358
Total included Articles included in full list: 37 * Articles included in manuscript: 32 Total number of studies: 25
*
5 articles related to studies included in the review, however were not referenced in the manuscript. These articles are provided in the full reference list below.
Supplementary tables Indigenous social and emotional wellbeing research 16 May 2017
INDIGENOUS SOCIAL AND EMOTIONAL WELLBEING RESEARCH Table 1: Summary of included studies grouped according to methods Design
Mixed Methods
Author and Date Clifford et al 2011 (1) *
Approach to research Mixed methods
Study aim and focus Service delivery No implementation of intervention reported Alcohol misuse
Data collection Pre and post intervention surveys and interview
AIMhi study 3 Dingwell et al 2012 (2) *
Mixed methods
Service delivery No implementation of intervention reported (evaluation underway) SEWB
Interview and informal consultation
AIMhi Study 2 Nagel 2006 (3) *
Mixed methods
Observational SEWB
Survey and semi-structured interview
VUH study 3 Sun et al 2013 (4) *
Mixed methods
Service delivery Implementation of program reported SEWB
Qualitative comments, focus group, QoL questionnaire
Bakos 2008 (5, 6) #
Mixed methods: project
Focus groups, questionnaire, verbal feedback, evaluation form
Lovett et al 2014 (7) *
Mixed methods: description of development and implementation of a model Mixed methods: participatory action research followed by RCT Two-way learning
Service delivery Implementation of training reported Dual diagnosis (DA and SEWB) Service delivery Implementation of case management model reported Alcohol misuse Service delivery No implementation of intervention reported SEWB
Mixed method: interview, observation, field trip notes, music, photographs, videos, Health of the Nation Outcome Scale, K-10 wellbeing measure, health centre and hospital files and interview
AIMhi study 1 Nagel et al (8-14) *
Supplementary tables Indigenous social and emotional wellbeing research 16 May 2017
Survey
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INDIGENOUS SOCIAL AND EMOTIONAL WELLBEING RESEARCH Design
Qualitative
Author and Date Clifford et al 2012 (15)
*
Approach to research Qualitative
Esler et al 2007 (17) *
Qualitative
Raphael et al 2010 (19) * Williamson et al 2010 (20) * Allan 2010 (21) *
Qualitative
Carey 2013 (22) *
Qualitative: evaluation, cross-sectional Qualitative: evaluation Two-way learning Qualitative: participatory action research and social ecological perspective Two-way learning Qualitative: participatory action research Qualitative: phenomenological approach Qualitative: report
Harris et al 2007 (23) * Robinson et al 2004 (24)# Cargo et al 2012 (25) * Dawson et al 2012 (26) *
Fletcher et al 2011 (27) *
Bond et al 2012 (28) *
Higgins et al 2013 (29) #
Qualitative: sociological action research
Study aim and focus Service delivery No implementation of intervention reported (to inform intervention in (1, 16)) Alcohol misuse Service delivery No implementation of intervention reported (to inform intervention in (18)) Depression
Data collection Semi-structured group interview
Observational SEWB Service delivery No implementation of intervention reported DA and SEWB Evaluation SEWB Evaluation Mental health (AMHW) Observational Smoking cessation
Focus group and semi-structured interview
Workplace policy Smoking cessation
Yarning, research staff notes, flipcharts and survey
Observational Smoking cessation
Semi-structured interview
Service delivery Implementation of some intervention/s reported Anxiety or depression
Focus groups and interviews
Supplementary tables Indigenous social and emotional wellbeing research 16 May 2017
Focus group
Semi-structured interview
Semi-structured interview Semi-structured interview, observation and record audit Focus group and interview
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INDIGENOUS SOCIAL AND EMOTIONAL WELLBEING RESEARCH Design
Quantitative
Author and Date Lee et al 2014 (30) *
Approach to research Qualitative: descriptive
AIMhi PDP Haswell-Elkins et al 2009 (31) * Clifford et al 2013 (16) *
Qualitative: description of a research partnership Quantitative
Esler et al 2008 (18) *
Quantitative
VUH study 1 Sun et al 2015 (32) * Sun et al 2013 (33) *
Quantitative
VUH study 2 Sun et al 2013 (34) *
Quantitative
Study aim and focus Observational Dual diagnosis (DA and SEWB) Report on partnership SEWB
Data collection Semi-structured interview
Service delivery No implementation of intervention reported Alcohol misuse Evaluation (validation of measure) Depression Service delivery Implementation of program reported SEWB
Patient medical records were extracted
Meetings, literature review, interviews
Validation study (semi-structured interview) QoL questionnaire
Service delivery QoL questionnaire Implementation of program reported SEWB Calabria et al 2013 (35) * Quantitative Service delivery 1: Descriptive survey * Calabria et al 2014 (36) No implementation of intervention reported 2: Cross-sectional survey Alcohol misuse Case study DiGiacomo et al 2007 (37) # Case study Report on intervention Smoking cessation Patient medical records were reviewed Abbreviations: AMS – Aboriginal Medical Service; AMHW – Aboriginal Mental Health Worker; AIMhi - Australian Integrated Mental Health Initiative/Aboriginal and Islander Mental Health Initiative; DA – drug and alcohol; PHC – primary health care; PHCS – primary health care service; QoL – quality of life; RCT – randomised control trial; SEWB – social and emotional wellbeing; VUH - Voices United for Harmony Study aim definitions: Service delivery: focused on developing or implementing PHC intervention/service. Includes: implemented (where implementation of intervention is reported) or not implemented (where no implementation of intervention are reported). Excludes evaluations. Evaluation: focused on evaluating an existing intervention/service/policy/program. Includes validation of clinical measures. Observational: focused on collecting observational data only, with no intervention description Report: description of intervention or partnership no research conclusions provided Workplace policy: focused on developing a new workplace policy * Journal article format # Report formal
Supplementary tables Indigenous social and emotional wellbeing research 16 May 2017
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INDIGENOUS SOCIAL AND EMOTIONAL WELLBEING RESEARCH Table 2: Summary of key learnings identified during risk of bias and community acceptance assessment Author and Date
Primary outcome identified and met
Risk of bias ¥
Clifford et al 2011 (1)
Identified and met: Yes Outcome: Identify perceptions
H
Community acceptance score ¥ 0/4
AIMhi study 3 Dingwell et al 2012 (2)
Identified and met: Yes Outcome: Assess resource
L
Unclear #
AIMhi Study 2 Nagel 2006 (3)
Identified and met: Unclear Outcome: Unable to determine
H
Unclear #
VUH study 3 Sun et al 2013 (4)
Identified and met: Yes Outcome: Evaluate program
H
2/4
Bakos 2008 (5, 6)
Identified and met: Unclear Outcome: Unable to determine
N/A *
0/4
Lovett et al 2014 (7)
Identified and met: Unclear Outcome: Unable to determine
N/A *
Unclear #
AIMhi study 1 Nagel et al (8-14)
Identified and met: Yes Outcome: Evaluate intervention
H
2/4
Supplementary tables Indigenous social and emotional wellbeing research 16 May 2017
Key learnings
Mixed methods - When mixed-method studies include an RCT, flexible randomisation processes may increase acceptability. Examples include: VUH study 3 – modified to non-randomised design in response to community feedback. Participants selfselected into intervention group (resulting in selection bias). AIMhi study 1 – intervention was delivered according to ‘early’ and ‘late’ groups (potentially resulting in exposure to different external factors, and reducing the likelihood of concealment/blinding). - PAR processes can be used to develop localised interventions: AIMhi study 1 – PAR was completed in initial stages of the study to inform intervention development. - Mixed-methods can incorporate two-way learning principles. - The various approaches and reporting by authors resulted in challenges assessing the risk of bias and community acceptance of mixed-method studies.
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INDIGENOUS SOCIAL AND EMOTIONAL WELLBEING RESEARCH Author and Date
Primary outcome identified and met
Risk of bias ¥
Clifford et al 2012 (15)
Identified and met: Yes Outcome: Identify perceptions
H
Community acceptance score ¥ 1/4
Esler et al 2007 (17)
Identified and met: Unclear Outcome: Unable to determine
M
4/4
Raphael et al 2010 (19) Williamson et al 2010 (20) Allan 2010 (21)
Identified and met: Yes Outcome 1: Identify perceptions Outcome 2: Assess resource Identified and met: Yes Outcome: Identify perceptions
M
2/4
M
0/4
Carey 2013 (22)
Identified and met: Yes Outcome: Evaluate service
?/H ^
2/4
Harris et al 2007 (23) Robinson et al 2004 (24)
Identified and met: Unclear Outcome: Unable to determine
N/A *
1/4
Cargo et al 2012 (25) Dawson et al 2012 (26)
Identified and met: Yes Outcome 1: Determine barriers Outcome 2: Identify perceptions Identified and met: Somewhat met Outcome: Develop/evaluate policy
L
4/4
M
4/4
Identified and met: Yes Outcome: Identify perceptions Identified and met: Unclear Outcome: Unable to determine
L
4/4
H
3/4
Lee et al 2014 (30)
Identified and met: Yes Outcome: Identify perceptions
L
1/4
AIMhi PDP Haswell-Elkins et al 2009 (31)
Identified and met: Unclear Outcome: Unable to determine
N/A *
3/4
Fletcher et al 2011 (27) Bond et al 2012 (28) Higgins et al 2013 (29)
Supplementary tables Indigenous social and emotional wellbeing research 16 May 2017
Key learnings
Qualitative designs - Qualitative designs appear to have lower risk of bias and higher acceptability than mixed-method or quantitative designs. - PAR, social ecological perspectives and phenomenological approaches appear to encourage research processes that lead to community acceptance. - Most qualitative research outcomes did not result in the implementation of interventions e.g. were limited to identifying perspectives. - Two-way learning principles may enhance research deemed to have low risk of bias and high community acceptance (25, 26).
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INDIGENOUS SOCIAL AND EMOTIONAL WELLBEING RESEARCH Author and Date
Primary outcome identified and met
Risk of bias ¥
Clifford et al 2013 (16)
Identified and met: Yes Outcome: Evaluate intervention Identified and met: Yes Outcome: Assess resource
?/H ^
Community acceptance score ¥ 1/4
Key learnings
Quantitative - All quantitative designs were assessed as high risk of bias, or were unable to be assessed. This indicates there are Esler et al 2008 (18) ?/H ^ 4/4 challenges implementing qualitative research with Indigenous communities. - Most quantitative studies involved processes that indicate community acceptance. This may suggest that close collaboration is necessary when conducting qualitative VUH study 1 Sun et al Identified and met: Yes H 3/4 research: 2015 (32) Sun et al 2013 Outcome: Evaluate program (33) Esler – appears to be driven by AMS. First author was an AMS staff member, study was approved by AMS VUH study 2 Sun et al Identified and met: Yes H 2/4 governance structure and staff were involved in data 2013 (34) Outcome: Evaluate program collection, Calabria et al 2013 (35) Identified and met: Yes ?/H ^ 3/4 Calabria – study was approved by AMS governance Calabria et al 2014 (36) Outcome 1: Assess tool’s acceptability structure, research tools were localised and staff were Outcome 2: Identify cut-off points involved in data collection and reporting, Sun – study was approved by AMS governance structure, Community Leaders were involved in design and implementation and staff coordinated activities. ^ # DiGiacomo et al 2007 (37) Identified and met: Unclear ?/H Unclear Case Study Outcome: Unable to determine - Due to this study’s aim (report on intervention) no conclusions regarding case studies can be drawn. Colour key High risk of bias / community acceptance score =