Smoking, poor Nutrition, Alcohol misuse and Physical inactivity (SNAP risk factors) are universally recognised as key behavioural risk factors for chronic disease.1,2 Indigenous Australians experience a disproportionately greater burden of harm from SNAP risk factors than the general Australian population.3 Compared to the general Australian population, Indigenous Australians are between two and seven times more likely to die from a tobacco-related disease;4 be hospitalised for an alcohol-related condition,5,6 and develop an obesity-related disease.7
Despite the disproportionately high burden of SNAP-related harm borne by Indigenous Australians, the number of Indigenous-specific intervention programs,8 including associated resource materials,9 to address this harm are less than optimal, and evaluations of Indigenous-specific SNAP interventions implemented to date, appear to be inadequate, both in terms of their quantity10 and their quality.11,12 With regard to quantity, a review of Indigenous health research found that approximately 10% of original research publications for specific time periods between 1987 and 2003 (inclusive) were intervention studies, while approximately 81% were descriptive studies.10 With regard to quality, a review of alcohol interventions targeting Indigenous Australians in 2000 found that less than 25% were published in peer-reviewed journals, leading the authors to conclude that, while a broader range of interventions ought to be implemented, these needed to be more rigorously evaluated in collaboration with Indigenous communities.11
A critical methodological review of evaluations of Indigenous-specific SNAP intervention studies published in the peer review literature is timely for at least two reasons. First, there have been no systematic critical reviews to date of nutrition or physical activity interventions targeting Indigenous Australians. Second, existing reviews of the alcohol and smoking literature focus on identifying and describing the types of Indigenous-specific intervention research, rather than examining their methodological quality.11,12 Therefore, this paper has two aims: to critique the methodological and contextual aspects of evaluations of Indigenous-specific SNAP intervention studies; and to examine the effect of these studies on reducing SNAP-related harm in Indigenous Australian communities.