Dr Samantha Bateman1,2, Dr Michael Riceman1,2, Ms Kelli Owen1,2, Ms Rhanee Lester1, Ms Nari Sinclair1, A/Prof Odette Pearson1,3, Prof Stephen McDonald1,2, Dr Martin Howell4,5, Dr David Tunnicliffe4,5, A/Prof Shilpanjali Jesudason1,2
1Faculty of Health and Medical Sciences, University Of Adelaide, Adelaide, Australia, 2Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, Australia, 3Wardliparingga Aboriginal Health Equity Unit, South Australian Health and Medical Research Institute, Adelaide, Australia, 4Sydney School of Public Health, The University of Sydney, Sydney, Australia, 5Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia
Aim: To identify how disparities in health outcomes for First Nations Peoples of colonised countries living with kidney failure are addressed through models of care.
Background: First Nations Peoples of colonised counties are disproportionately burdened kidney failure. Current systems of kidney care fail to meet the needs of First Nations people despite strong advocacy from community.
Methods: We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist, governed by the Aboriginal Kidney Care Together Improving Outcomes Now (AKction) reference group. Included studies involved First Nations Peoples of Australia, New Zealand, Canada and the United States of America and interventions to address the management or complications of kidney failure. The certainty of the evidence was assessed against the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria.
Results: We identified 31 studies across 5 domains: dialysis care, dialysis access (vascular/peritoneal), transplantation, kidney failure complications, nutrition, and cultural safety. Few First Nations-specific randomised trials were identified. The largest body of evidence related to community-based dialysis care; however the certainty of findings was low. A moderate certainty of evidence was identified for First Nations-specific programs to manage psychological impacts of kidney failure, increase transplant awareness, and improve cultural safety and responsiveness of health systems through empowering First Nations reference groups.
Conclusions: Few intervention studies have evaluated First Nations specific models of kidney care. Given the inequities faced by First Nations Peoples of colonised countries, this paucity of research is unacceptable. Within the limited literature, there is evidence that purposeful, First Nations-led interventions can have positive impacts that are clinically safe, cost effective and acceptable to patients, staff, and the community.
Biography:
Dr Samantha Bateman is a white clinician-researcher who lives and works on Kaurna Yerta. She is dedicated to working and walking alongside Aboriginal Peoples to improve health outcomes for those living with kidney disease. She is currently completing a PhD investigating the benefits and burdens of kidney transplantation for Aboriginal and Torres Strait Islander Australians and is a chief investigator on the co-created Aboriginal Kidney Care Together Improving Outcomes Now (AKction2) project.