By capturing the experiences of Indigenous women and their health workers through ‘yarning’ methodology, a Heart Foundation researcher is helping pregnant Aboriginal and Torres Strait Islander women stop smoking.

Heart Foundation researcher Michelle Bovill’s worki engages with Aboriginal and Torres Strait Islander women and their health workers to co-develop health information appropriate for their communities. The research forms part of an article she has co-authored in the current issue of the International Journal of Environmental Research and Public Health.

A Wiradjuri woman, Ms Bovill said it was important to make sure smoking cessation information and tools were developed specifically for Australian and Torres Strait Islander women, who are three times more likely to smoke during pregnancy than non-Indigenous Australian pregnant women.

“Developing effective health promotion interventions and resources requires more than a “culturally appropriate” adaptation of mainstream resources.”

“Smoking leads to low birth weights and affects the development of the baby, which increases the risk of chronic diseases, including heart disease, which significantly impacts the life expectancy of Aboriginal people in Australia,” she said.

“We want to ensure every Aboriginal woman is given the means and motivation to choose to cease smoking during pregnancy.”

In the published articleii, University of Newcastle researchers say an Australian-first method of working across Aboriginal communities and health workers to assess and tailor messages could improve Indigenous health promotion interventions and research.

The smoking cessation information materials reviewed by the study included a manual and guide for health workers, brochures for the pregnant Aboriginal and Torres Strait Islander women, and a flipchart for health workers and their patients to explore the topic together.

The educational resources were assessed in four steps through a scientific review by an expert panel, a suitability scoring by Aboriginal health workers, readability scores and yarning circles (focus groups) with both Aboriginal and Torres Strait Islander women and health professionals at three Aboriginal medical services in New South Wales, South Australia and Queensland.

By using yarning circles – an important style of conversation and story-telling used by Indigenous peoples from around the world for centuries to build respectful relationships, and to learn, preserve and pass on cultural knowledge – Ms Bovill was able to build trust with focus group participants and create a culturally safe, collaborative environment.

Materials to educate and support smoking cessation in pregnancy were improved by using engaging pictures of Aboriginal women and babies, interactive content, and visual aids such as videos to reach highest level of medical education and awareness whilst delivered in non-confrontational and supportive way.

The new materials are now being trialled across the three participating states and a further three Aboriginal Medical Services, with results due to be published early 2019.

“Smoking in pregnancy is a national priority for the long-term health of Aboriginal and Torres Strait Islander peoples. Innovative interventions are needed to address this priority in culturally responsive and empowering ways. Aboriginal women need to be advised to quit, not reduce, smoking during pregnancy and offered appropriate intensive support to empower quit attempts.

“By publishing our methodology, I hope that more projects can be inspired to use collaborative methods for developing appropriate Indigenous health promotion materials and interventions, that are meaningful to Aboriginal and Torres Strait Islander peoples and communities and effect real change in health inequity.”

In their article, the researchers called for a national “bank” of validated educational resources to be developed by national peak organisations and/or the Department of Health to reduce uneconomical use of resources and time in developing health information.

Heart Foundation National CEO Adjunct Professor John Kelly said the research was very promising.

“The latest Heart Foundation’s Heart Maps, released earlier this month, show that Indigenous Australians are overrepresented in all statistics relating to heart disease hospitalisation, deaths and risk factors, and anything we can do to change that is a step in the right direction,” he said.

“Thanks to our generous donors, the Heart Foundation is able to make important research such as this happen.”

To find out more about the Heart Foundation’s research program or to make a donation, visit heartfoundation.org.au or call 13 11 12.