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Evaluation of a Pragmatic Community-Tailored Physical Activity Program with Aboriginal and Torres Strait Islander People

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Evaluation of a Pragmatic Community-Tailored Physical Activity Program with Aboriginal and Torres Strait Islander People ResearchOnline@JCU This file is part of the following work: Sushames, Ashleigh (2018) Evaluation of a pragmatic community-tailored physical activity program with Aboriginal and Torres Strait Islander people. PhD Thesis, James Cook University. Access to this file is available from: https://doi.org/10.25903/5c3fb480ec5f0 Copyright © 2018 Ashleigh Sushames The author has certified to JCU that they have made a reasonable effort to gain permission and acknowledge the owners of any third party copyright material included in this document. If you believe that this is not the case, please email [email protected] Evaluation of a pragmatic community-tailored physical activity program with Aboriginal and Torres Strait Islander people A dissertation submitted to James Cook University in fulfilment of the requirements for the degree of Doctor of Philosophy (Sport and Exercise Science) By Ashleigh Sushames B.A., SpExSc (Hons) 2018 Acknowledgements Firstly, I would like to thank all the people who participated in my research projects, including my friends who fell for my “I need a small favour” speech. You guys are the best! I would like to acknowledge Professor Andrew Edwards for inspiring and leading me down the path of research. I would like to thank my supervisory team, Dr Klaus Gebel, Professor Robyn McDermott and Associate Professor Terry Engelberg for their guidance, support and knowledge which has seen me through to the end. Dr Jacki Mein, you have also been an incredible support, and I truly would like to thank you for your willingness to involve Apunipima with the research project. The community of Mossman and Julie Salam also have my respect and appreciation for allowing me into their community and trusting me. I would like to express the deepest gratitude to my peer support network who encouraged and guided me through tough times: Jessica Wood, Sean Taylor, Cameron Murphy, Peter Malouf, Serena Kuring and Brenton Ricci. There are not enough words to express how thankful I am to have you guys to talk to, proof-read drafts and to take on sushi dates. I would also like to acknowledge the other members of the Centre for Chronic Disease Prevention: Sally McDonald, Dympna Lenard, Mary O’Loughlin, Fintan Thompson, Dr Linton Harris, Julie Woodward and Dr Sandra Campbell. Thank you for all the advice, mentoring, deep and meaningful chats when I felt down and your time to help me over the past few years. There is not enough space to write about all the ways in which you have helped me, but I am most certainly glad you all gave me free reign to terrorise the office. I would also like to thank Dr Melissa Crowe and the Cohort Doctoral program for being a caring and supportive network of people and I am glad that I got to be part of the program. I would also like to acknowledge the APA scholarship support I received during my PhD, as i well as the grants awarded by James Cook University and the FNQ Hospital Foundation which helped to fund the cost of my research. I would like to thank my grandmother Lorraine for being a continuous support throughout the past few years. A special mention to the rest of my family and friends for keeping me sane and just, in general, being absolute legends. Finally, I would like to thank my partner Milton Mossman for your love and support. I am looking forward to the next adventure in our lives when our baby Milo arrives. ii Statement of the contribution of others Nature of Assistance Contribution Names, Titles and Affiliations of Co-Contributors Primary Supervision Dr Klaus Gebel: Centre for Chronic Disease Prevention (CCDP), Australian Institute of Tropical Health and Medicine & College of Public Health, Medical and Veterinary Sciences, James Cook University School of Allied Health, Faculty of Health Sciences, Australian Catholic University Prevention Research Collaboration, Sydney School of Public Health, University of Sydney Secondary Supervision Professor Robyn McDermott: Centre for Chronic Disease Prevention (CCDP), Australian Institute of Tropical Health and Medicine & College of Public Health, Medical and Veterinary Sciences, James Cook University Associate Professor Terry Engelberg: College of Healthcare Sciences, James Cook University Mentors Professor Andrew Edwards: Dean (Faculty of Sport & Health Sciences), University of St Mark & St John Dr Melissa Crowe: College of Healthcare Science, James Cook University Fintan Thompson: Data Manager, Centre for Chronic Disease Prevention (CCDP), Australian Institute of Tropical Health and iii Medicine & College of Public Health, Medical and Veterinary Sciences, James Cook University Stipend I received an Australian Postgraduate Award (APA) from the Australian Government Financial support Research Infrastructure Block Grant, James Cook University, $6,600 FNQ Hospital Foundation grant: $23,880 In-kind support Centre for Chronic Disease Prevention, James Cook University: Use of vehicle, equipment, office space, computers and printing. ___________________ 28/2/2018 Signature Date iv Statement on sources The material presented in this thesis titled “Evaluation of a pragmatic community- tailored physical activity program with Aboriginal and Torres Strait Islander people” is my own work and has not been submitted for the award of any other degree or diploma in any other university or institution or tertiary education provider. To the best of my knowledge, this thesis contains no material previously published or written by another person, except where due reference is made in the text. 28/2/2018 Signature Date v Statement on access I, the undersigned, the author of this thesis, which is in the fulfilment of the requirement for the degree of Doctorate of Sport & Exercise Science, understand that James Cook University will make it available for use within the university library and, via the Australian Digital Theses network, for use elsewhere. I understand that, as an unpublished work, a thesis has significant protection under the Copyright Act and; I do not wish to place any restriction on access to this thesis. ___________________ 28/2/2018 Signature Date vi Declaration on ethics The research presented and reported in this thesis was conducted within the guidelines for research ethics outlined in the National Statement on Ethics Conduct in Research Involving Humans (1999), the Joint NHMRC/AVCC Statement and Guidelines on Research practice (1997), the James Cook University Statement and Guidelines on Research Practice (2001). The proposed research methodology received clearance from the James Cook University Experimentation Ethics Review Committee (approval numbers H5763 and H5942). ___________________ 28/2/2018 Signature Date vii Preface Statement: Positioning of the Researcher I am a non-Indigenous Australian woman who was born and raised in Darwin, Northern Territory. I spent my adolescent years living on the remote island of Groote Eylandt, which is the homeland of, and is owned by, the Warnindhilyagwa people. I left Groote Eylandt and moved to Cairns (Far North Queensland) for my high school education, as there were no high schools on the island. After high school, I went straight to university to study Sport and Exercise Science as I had a passion for sport and health. I have played representative rugby union and soccer for many years and it was through my sporting commitments that I made the connections with some of my Indigenous mentors. During my undergraduate degree, I realised that my true passion was to improve the quality of life of Indigenous people and I was lucky enough to have a well-respected honours supervisor who worked in Indigenous communities and helped me to expand my network by introducing me to her collaborating partners. While living on Groote Eylandt, I witnessed the health inequalities between Indigenous and non-Indigenous people, and had a firsthand experience of how living remotely can affect a person’s ability to access resources and can limit educational opportunities. I learnt about the inter-generational trauma that still exists in Indigenous societies and feel strongly that more work needs to be done to close the life expectancy gap between Indigenous and non-Indigenous Australians. Prior to conducting my studies, it was important to me to understand my positional standpoint in relation to my research process. As a researcher, I believe in pragmatist epistemology as I see the importance of practical consequences.1 I also recognise and respect viii the ontological relationship that Aboriginal and Torres Strait Islander people have with the land and the sea, and I acknowledge that the social position that an Indigenous Australian may have politically and culturally will be different from my own. 1. Morgan DL. Pragmatism as a paradigm for social research. Qualitative Inquiry. 2014;20(80):1045–53. doi: 10.1177/1077800413513733 ix Abstract The health inequalities between Indigenous and non-Indigenous Australians, and the benefits of physical activity in the prevention and treatment of chronic diseases are well known. Yet, little research has been conducted on physical activity and health outcomes for Aboriginal and Torres Strait Islander people. The Australian physical activity guidelines, recommend that adults should accumulate 150-300 minutes per week of moderate activity or 75-150 minutes of vigorous activity or equivalent combinations of both. Currently, 47% of Aboriginal and Torres Strait Islanders in non-remote locations are sufficiently physically active, 0.9 times that of non-Indigenous Australians. The purpose of this thesis was to investigate ways to improve the health of Indigenous Australians through a physical activity program. The first major aim (Study 1) was to synthesise previous evaluations of physical activity interventions implemented with Indigenous people in Australia and New Zealand and, based on this, to identify gaps in the literature and to recommend an agenda for future research in this field. The second aim (Study 2) was to assess the reliability and validity of the Fitbit Flex for measuring physical activity levels, as this device would be used in the succeeding study.
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