. 2022 Jan 21;20(1):12.

doi: 10.1186/s12961-022-00813-6.

First Nations Australians' self-determination in health and alcohol policy development: a Delphi study

Annalee E Stearne^{1

2}, K S Kylie Lee^{3

4

5

6

7

8}, Steve Allsop^{3

4}, Anthony Shakeshaft⁹, Michael Wright¹⁰

Affiliations

¹ Faculty of Health Sciences, National Drug Research Institute, Curtin University, Perth, Western Australia, Australia. a.stearne@curtin.edu.au.
² Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Western Australia, Australia. a.stearne@curtin.edu.au.
³ Faculty of Health Sciences, National Drug Research Institute, Curtin University, Perth, Western Australia, Australia.
⁴ Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Western Australia, Australia.
⁵ Faculty of Medicine and Health, Central Clinical School, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, New South Wales, Australia.
⁶ The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, New South Wales, Australia.
⁷ Burnet Institute, Melbourne, Victoria, Australia.
⁸ Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria, Australia.
⁹ National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
¹⁰ Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.

PMID: 35062976
PMCID: PMC8777453
DOI: 10.1186/s12961-022-00813-6

First Nations Australians' self-determination in health and alcohol policy development: a Delphi study

Annalee E Stearne et al. Health Res Policy Syst. 2022.

. 2022 Jan 21;20(1):12.

doi: 10.1186/s12961-022-00813-6.

Authors

Annalee E Stearne^{1

2}, K S Kylie Lee^{3

4

5

6

7

8}, Steve Allsop^{3

4}, Anthony Shakeshaft⁹, Michael Wright¹⁰

Affiliations

¹ Faculty of Health Sciences, National Drug Research Institute, Curtin University, Perth, Western Australia, Australia. a.stearne@curtin.edu.au.
² Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Western Australia, Australia. a.stearne@curtin.edu.au.
³ Faculty of Health Sciences, National Drug Research Institute, Curtin University, Perth, Western Australia, Australia.
⁴ Faculty of Health Sciences, enAble Institute, Curtin University, Perth, Western Australia, Australia.
⁵ Faculty of Medicine and Health, Central Clinical School, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, New South Wales, Australia.
⁶ The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, New South Wales, Australia.
⁷ Burnet Institute, Melbourne, Victoria, Australia.
⁸ Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria, Australia.
⁹ National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
¹⁰ Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.

PMID: 35062976
PMCID: PMC8777453
DOI: 10.1186/s12961-022-00813-6

Abstract

Background: Recognition of the role of structural, cultural, political and social determinants of health is increasing. A key principle of each of these is self-determination, and according to the United Nations (2007), this is a right of Indigenous Peoples. For First Nations Australians, opportunities to exercise this right appear to be limited. This paper explores First Nations Australian communities' responses to reducing alcohol-related harms and improving the health and well-being of their communities, with a focus on understanding perceptions and experiences of their self-determination. It is noted that while including First Nations Australians in policies is not in and of itself self-determination, recognition of this right in the processes of developing health and alcohol policies is a critical element. This study aims to identify expert opinion on what is needed for First Nations Australians' self-determination in the development of health- and alcohol-related policy.

Methods: This study used the Delphi technique to translate an expert panel's opinions into group consensus. Perspectives were sought from First Nations Australians (n = 9) and non-Indigenous Peoples (n = 11) with experience in developing, evaluating and/or advocating for alcohol interventions led by First Nations Australians. Using a web-based survey, this study employed three survey rounds to identify and then gain consensus regarding the elements required for First Nations Australians' self-determination in policy development.

Results: Twenty panellists (n = 9 First Nations Australian) participated in at least one of the three surveys. Following the qualitative round 1 survey, six main themes, 60 subthemes and six examples of policy were identified for ranking in round 2. In round 2, consensus was reached with 67% of elements (n = 40/60). Elements that did not reach consensus were repeated in round 3, with additional elements (n = 5). Overall, consensus was reached on two thirds of elements (66%, n = 43/65).

Conclusions: Self-determination is complex, with different meaning in each context. Despite some evidence of self-determination, systemic change in many areas is needed, including in government. This study has identified a starting point, with the identification of elements and structural changes necessary to facilitate First Nations Australian community-led policy development approaches, which are vital to ensuring self-determination.

Keywords: Alcohol; Australia; First Nations Australians; Policy development; Rights; Self-determination.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

**Fig. 1**
Ranking of First Nations Australian representation in policy development

**Fig. 2**
Stages of First Nations Australians’ inclusion in policy development

See this image and copyright information in PMC

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First Nations Australians' self-determination in health and alcohol policy development: a Delphi study

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First Nations Australians' self-determination in health and alcohol policy development: a Delphi study

Authors

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Conflict of interest statement

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