Characterising health promotion in Aboriginal and Torres Strait Islander languages: A content analysis of COVID-19 and maternal health resources

Abstract

Issue addressed: Health promotion resources in Aboriginal and Torres Strait Islander (Indigenous) languages are being widely translated and disseminated at the community, health service and government level. In addition to outlining the relevant Australian policy context and evidence base, this study sought to describe the availability and characteristics of COVID-19 and maternal health promotion resources incorporating Indigenous languages.

Methods: Health promotion resources published online between June 2005 and June 2020 were identified by a desktop scan and screened against quality inclusion criteria. A content analysis by resource type, health topic, purpose, use of language and source was conducted.

Results: A total of 215 resources was eligible for inclusion, incorporating 50 different Indigenous languages and representing a varied approach to language use and health promotion. Almost 7 times as many COVID-19 resources were identified than maternal health materials.

Conclusions: In contrast to maternal health, COVID-19 has seen a sharp rise in the number of health promotion resources produced in language, especially in formats capable of streamlined replication in multiple languages. Strong use of narrative, storytelling and alternative primary aims such as language education suggests potential for greater collaboration between health promotion organisations and other community groups and services. Bilingual resources may have applications for communities where traditional language knowledge is being reawakened. SO WHAT?: Emerging capacity to efficiently produce health promotion resources in multiple Indigenous languages could be capitalised for health topics beyond COVID-19. However, further research in determining best practice and user perspectives is essential in guiding the development of these resources.

Keywords: Aboriginal and Torres Strait Islanders; culturally and linguistically diverse people; health equity; health literacy; health policy.

FIGURE 1

Search plan for online review of COVID‐19 and maternal health promotion resources incorporating Aboriginal and Torres Strait Islander languages, including search terms, sources, and eligibility criteria. Using this search plan 215 resources were identified for inclusion in the study

FIGURE 2

Distribution of Indigenous languages used in a sample of 215 COVID‐19 and maternal health promotion resources in language, by geographic location of traditional homeland and number of times language identified. This heatmap, produced in a web‐enabled heat mapping program, demonstrates the geographic distribution of languages used in the results of a desktop review of health promotion resources, as determined by content analysis. Geographic localisation of languages has been coded according to the Australian Institute of Aboriginal and Torres Strait Islander Studies AUSTLANG Database. Where longitude and latitude coordinates were not provided, the geographic coordinates of an appropriate Aboriginal Language Centre/Land Council were used. ^†Kriol and ^‡Yumplatok are non‐traditional Indigenous languages and incorporate several dialects. For the purposes of this graph these languages have been mapped in a single location, however their true distribution of origin extends across a far wider region of Australia and the Torres Strait

FIGURE 3

Month/ year of publication of resources in a sample of 215 COVID‐19 and maternal health promotion resources in language, by health topic and number of resources identified. This graph, produced in Excel, indicates the incidence of the publication of health promotion resources using Indigenous languages between June 2005 to June 2020. 215 resources were published in 27 different months, with maternal health resources spanning June 2005 to January 2019, and COVID‐19 resources spanning January 2020 to June 2020. The maximum number of maternal health resources coded to a single month was 4 (January 2015), and the maximum number of COVID‐19 resources coded to a single month was 83 (January 2020). Date published was determined by content analysis of the results of a desktop review

FIGURE 4

Approach to translation in a sample of 215 COVID‐19 and maternal health promotion resources incorporating Indigenous languages, by approach and percentage of all resources. This chart, produced in Excel, illustrates the distribution of approaches to translation of resources using Indigenous languages between June 2005 to June 2020. Approach to translation is defined as follows to distinguish between resources replicated into multiple different languages from an English template or tailored to the local context: “Replicated resource (series)” refers to resources from a series of identical resources excluding language used, “Individualized resource (series)” refers to resources from a series of non‐identical resources, and “Individualized resource (single)” refers to resources not part of a series. Approach to translation was determined by content analysis of the results of a desktop review