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Understanding the impact of COVID-19 on health beliefs and compliance with prevention measures in rural, regional, remote and Aboriginal populations of Western NSW.

Activity: Engagement case studies › Government

Description

In this case study, we will demonstrate how working as a team of First Nations and non-First Nations researchers, in partnership with the Western NSW Local Health District (WNSWLHD), to understand the impact of COVID-19, led to a significant engagement activity.
The engagement activity was the successful dissemination of our findings through an article in The Conversation with the intention to influence the way the media communicated about the levels of risk for First Nations Australians. Specifically, because of the way we conducted the research, we identified significantly higher levels of fear and anxiety in the First Nations community. To raise awareness of this disparity and influence the media discourse on the vulnerability of First Nations Australians, we published an article in The Conversation, sharing our findings and concerns. As we will show, this article gained immediate traction and attention at a local, national and international level. It also influenced the discourse in national and international research around the need for community-led and designed communication and contributed to research about the impact of heightened fear on the mental health of First Nations people in Australia and Canada.
NB: We use the terms First Nations and Aboriginal people in this case study. The term Aboriginal people was preferred by the members of the Aboriginal Reference Group who provided governance for this project.

Role

Our partnership with the WNSWLHD was the first aspect of engagement. Building on a relationship with industry developed through the Health Services Research Faculty Research Area, we (Oliver Burmeister and Jodie Kleinschafer) partnered with the WNSWLHD (Julaine Allan and Teesta Saksena)(and others Mark and Jayne discussed below) on a grant application and were awarded $28,000 COVID funding from CSU.  We worked together to conduct this six-month mixed-methods research project.  The WNSWLHD proposed the project, co-designed the research, and provided an understanding of the context and the importance of the research.  Further, as a newly graduated PhD, this project provided an opportunity for Teesta to develop her capacity as a researcher in the WNSWLHD.  With our collaborators from the LHD, we co-produced a research report of the findings for the WNSWLHD and two research articles.

A key focus of our research was privileging the First Nations' voice, and our research team included Jayne Lawrence, a Wiradjuri woman (TRUDRH) and Mark Lock, a Ngiyampaa man (Independent indigenous researcher). As 13% of the population in the WNSWLHD were Aboriginal (compared to 3.4% in the rest of the state), we made a purposeful intention to Winhangarra (a Wiradjuri word meaning 'Listen, Hear, Think') about the experiences of First Nations people in the region.  Because of our research design, we had a high level of engagement from Aboriginal participants in the research (8.4%).  As a result, we made a surprising finding that First Nations respondents rated their chances of getting the virus in the next 12 months eight times higher than the non-First Nations sample.  We attributed the excessive levels of fear and anxiety to the way the media was reporting on the vulnerability of First Nations Australians. For this reason, we published and promoted a piece about these findings in The Conversation on the 15th of July 2022 to raise awareness of this heightened fear and to attempt to change the discourse.  This included

·        > producing a media release and

·        > members of the team providing interviews to NITV, SBS News ABC radio and Local News Papers and

·         > providing links to the more detailed research paper that explained these findings.

PurPurpose 

The project objectives were to assess the knowledge of COVID-19 among rural, regional, and remote communities in NSW, privileging the voice of Aboriginal populations. To determine perceptions of risk and preventive health behaviours during the pandemic. And finally, to identify the sources of information people are using, and which ones they rely on/trust.

In particular, we had identified a lack of research examining the information and communication needs of Aboriginal people and culturally safe community management plans. 

As a team of First Nations and Non-First Nations researchers, we purposefully set out to engage in culturally sensitive research that was equitable, inclusive and culturally responsive.  Several aspects of the project helped us to achieve this, including:

1) project leadership for this part of the research by PI Mark Lock and PI Jayne Lawrence,

2) support of an Aboriginal Community Controlled Health Organisation within the WNSWLHD footprint which supported the AH&MRC ethics application,

3) We began with the Aboriginal ethics review and approval, which, under Mark and Jayne’s guidance,  helped to achieve a tone of ‘Yindyamarra’ (doing respectfully, going slowly and to honour) for the project. 

4) An Aboriginal Reference Group for COVID-19 Research (ARG) met monthly and was actively involved in research design and implementation and provided governance for the 6-month duration of the project. 

This is important to the success of our engagement activity as it meant that we were confident in the authenticity of our findings. 

We found that fear among the First Nations respondents was eight times higher than the rest of the sample. As a team, we felt it was important to draw attention to this, as the fear level was damaging and unnecessary.     

For this reason, we published and promoted a piece about these findings in The Conversation on the 15th of July 2022 to raise awareness of this heightened fear and to attempt to change the discourse. This included producing a media release and members of the team providing interviews to NITV, SBS News, ABC radio and Local News Papers (Unfortunately, as a lot happened quickly, we did not keep information about all of these, but have included the evidence we have).

Importantly, Jayne Lawrence, as a Wiradjuri woman, was able to be the voice of her community in several of these interactions, e.g., SBS NITV. Our aim in sharing the findings was to highlight the inequity/ injustice of this experience and to influence the sensationalist discourse in the media about levels of risk faced by the First Nations members of the community.

This engagement activity also led people to the more detailed research paper associated with these findings. This paper has been cited 17 times, and a review of those papers revealed papers emphasising the importance of community-led and designed communication campaigns. (e.g., Greer et al., 2024; Lowell et al., 2024) and has contributed to investigations of the impact of heightened fear on different First Nations peoples and their mental health  during COVID (Adesunkanmi, 2023; Ieren, 2023; Norton et al., 2025). 

Inaddition, to sharing this information with the media, a report on the findingsof the project was also presented to the Aboriginal Community, including theAboriginal Reference Group (ARG), the CEO of the AH & MRC and CEO of theAboriginal Medical Service that supported the project and Bila Muuji, the Aboriginal-controlledorganisation that supported the work(https://bilamuujihealthservices.org.au/). We also produced a major report for the WNSWLHD. 

Outcomes 

The key outcome of this project was highlighting the excessive levels of fear created in the media and, in doing so, influencing the discourse about First Nations vulnerability.  Our piece in The Conversation was picked up and reproduced by National and International outlets (e.g. NZ, US, UK, South Africa, Singapore) and has been read by over 4500 people (The Conversation dashboard). The associated research publication, published at the same time, has had 17 citations, and has been referenced by 25 news outlets and is currently in the top 5% of all research outputs ever tracked by Altmetric" https://bmc.altmetric.com/details/130484825#score.

In addition, based on the success of our collaboration as First Nations and non-First Nations researchers, we developed an adapted value co-creation model to help other researchers seeking to do the same. This experience is documented in a methods paper, “Yindyamarra: Value co-creation with Aboriginal Australians which was co-authored by the research team and members of the Aboriginal Reference Group, Phillip Naden (Wiradjuri and Gamilaraay), Cassandra Gibbs (Gamilaraay), and Joe Gordon (Ngemba and Barranbinja).  

Another outcome of the project was capacity building across the team.  For instance, the members of the ARG developed more experience participating in research projects and writing up the results, Jodie learned about working with First Nations collaborators and the requirements for AH & MRC ethics and Jayne Lawrence has since embarked on a PhD. 

Further, Jayne and Jodie were invited to presentthis model of engagement to the Office of Research Services and GraduateStudies and so to use our learnings to support others to achieve the samesuccess in collaboration.

Pp

Period2020 → 2025
Work forWestern NSW Local Health District, Australia
Degree of RecognitionInternational

Sustainable Development Goals

  • SDG 3: Good Health and Well-Being
  • SDG 10: Reduced Inequalities

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