Smoking, nutrition, alcohol and physical activity interventions targeting Indigenous Australians: rigorous evaluations and new directions needed
Article first published online: 9 DEC 2010
© 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia
Australian and New Zealand Journal of Public Health
Volume 35, Issue 1, pages 38–46, February 2011
How to Cite
Clifford, A., Pulver, L. J., Richmond, R., Shakeshaft, A. and Ivers, R. (2011), Smoking, nutrition, alcohol and physical activity interventions targeting Indigenous Australians: rigorous evaluations and new directions needed. Australian and New Zealand Journal of Public Health, 35: 38–46. doi: 10.1111/j.1753-6405.2010.00631.x
- Issue published online: 8 FEB 2011
- Article first published online: 9 DEC 2010
- Submitted: June 2009 Revision requested: March 2010 Accepted: July 2010
- Indigenous population;
- intervention studies;
Objective: To describe and critique methodological aspects of interventions targeting reductions in smoking, poor nutrition, alcohol misuse and physical inactivity (SNAP risk factors) among Indigenous Australians.
Methods: An electronic search of eight databases and a manual search of reference lists of literature reviews and reference libraries for Indigenous-specific intervention studies published in peer-reviewed journals (January 1990 to August 2007) were undertaken. Alcohol, smoking, nutrition or physical activity needed to be the primary focus of the study and the intervention needed to specifically target Indigenous Australians.
Results: Twenty studies were selected for inclusion in the review. Methodologically, few studies employed randomisation or a control group, most omitted important details (e.g. costs), some did not report process measures (e.g. attrition rates), and some did not use validated measures. Two-thirds of interventions were implemented at the community level and employed multiple strategies.
Conclusion: There is a need for more rigorous evaluations of interventions targeting reductions in SNAP risk factors among Indigenous Australians, and to establish the reliability and validity of measures to quantify their effect.
Implications: It may be beneficial for future Indigenous-specific intervention research to focus on the evaluation of secondary prevention to complement the current concentration of effort targeting primary prevention. Community-wide interventions, combining strategies of greater intensity for high risk individuals with those of less intensity targeting lower risk individuals, might also offer considerable promise.