Introduction: Aboriginal Community Controlled Organisations (ACCOs) play a crucial role in supporting access to cervical screening for Aboriginal and Torres Strait Islander communities. This project aimed to collaborate with ACCOs to identify priorities and develop tailored support for implementing cervical screening and self-collection. Seven ACCOs across Victoria, representing diverse regions and models, participated in the project. While all offered self-collection, implementation approaches varied.

Methods: The project’s planning phase involved co-developing tailored implementation plans with each service, focusing on local priorities across the cervical screening pathway. Core activities included reviewing aggregate cervical screening data, conducting a baseline survey, holding a planning workshop, and completing end-line staff interviews. Services could also opt for additional evaluations, such as client experience surveys, staff training feedback, and data audits.

Common priorities across sites included health promotion and data focused quality improvement activities while service-specific activities focused on staff training (particularly non-GP staff), implementing cervical screening protocols, and ensuring culturally safe follow-up care. A consistent theme was the importance of culturally safe, accessible, and community-aligned service delivery.

Results: The project empowered ACCOs to lead meaningful implementation and evaluation activities, supported by the research team as needed. This approach respected community protocols and upheld principles of self-determination. Services reported increased screening participation, improved staff capabilities, stronger community engagement, and more effective follow-up care.

Findings from end-line interviews highlight both achievements and challenges in delivering cervical screening and follow-up services tailored to Aboriginal and Torres Strait Islander communities. Overall, the collaborative approach enabled ACCOs to design and implement service improvements based on community needs.

Discussion: This work demonstrates the effectiveness of co-developed, tailored implementation plans in supporting ACCOs to independently enhance cervical screening services. Such approaches are vital for boosting participation and ensuring care is culturally safe and responsive to community priorities.

Governance: This project upheld Indigenous leadership by engaging directly with Aboriginal Community Controlled Organisations (ACCOs), ensuring community leadership and decision-making were central throughout the research process. A project steering group, which included members from VACCHO, UniMelb, and ACCOs, provided guidance and expertise, ensuring the project aligned with community values and priorities. Throughout the project, we maintained regular communication with the participating sites, fostering a collaborative relationship that respected their input at every stage. A key component was a co-design workshop that allowed us to gain a deeper understanding of the sites' goals, what success looked like to them, and preferred ways of working. This workshop helped ensure the project was community-led and that the implementation strategies reflected the unique needs of each site. The project had a formally approved ethics application, ensuring that all research activities aligned with ethical standards. It was co-led by the University of Melbourne team and VACCHO (Victorian Aboriginal Community Controlled Health Organisation), demonstrating a collaborative approach that centered Indigenous leadership and perspectives. While there is currently no Indigenous ethics committee in Victoria, we took proactive steps to ensure that our ethics application complied with the National Statement on Ethical Conduct in Human Research, particularly Chapter 4.7, which addresses the specific needs and concerns of Aboriginal and Torres Strait Islander peoples. Furthermore, we adhered to the Ethical Guidelines for Research with Aboriginal and Torres Strait Islander Peoples, which served as a foundational framework for our research practices. We considered, recognised and displayed the core value of spirit and integrity by demonstrating our commitment in carrying out all five of the other core values of cultural continuity, equity, reciprocity, respect and responsibility which were each individually addressed in our ethics application.

Aboriginal communities face persistent housing challenges that undermine efforts to Close the Gap on health and socio-economic inequalities. Existing research is often fragmented and lacks a comprehensive view of the complex interplay between substandard housing, multiple health conditions, and socio-cultural determinants. This scoping review aims to map and synthesise existing evidence on housing conditions and their impact on health and socio-cultural determinants in Aboriginal communities.

A scoping review was conducted using Arksey and O’Malley’s methodological framework. Systematic searches were performed in October 2024 across PubMed/MEDLINE, ScienceDirect, Web of Science, Google Scholar and relevant websites to retrieve policy documents. Two independent reviewers screened all records, with a third resolving any disagreements. Studies published in English with no time restrictions were included if they reported on housing and health among Aboriginal populations. Data were synthesised thematically and findings reported following PRISMA-ScR guidelines.

Of 1,826 records screened, 87 studies were included, highlighting diverse housing challenges including structural deficiencies, functional inadequacies, persistent overcrowding and culturally inappropriate housing designs. Aboriginal populations experience significantly higher rates of infectious and non-communicable diseases, mental health disorders and widespread socio-cultural disruption as a result. The current Western-style housing design further marginalises Aboriginal communities by failing to reflect cultural norms and extended family living arrangements. Delayed maintenance, frequent policy changes, and chronic underfunding also contributed to fragmented, reactive responses. These conditions perpetuate housing inequity, undermine community wellbeing, and obstruct progress towards sustainable, culturally appropriate housing solutions and improved health outcomes.

Our findings confirm clear links between substandard housing conditions and adverse health outcomes. Western-oriented housing, delayed/inadequate maintenance, and reactive policy responses perpetuate a cycle of housing disadvantage. There is an urgent need for community-led solutions, long-term investment in culturally appropriate infrastructure, and policies that address the structural roots of housing disparity in Aboriginal communities.

Aboriginal Governance, Data Sovereignty and Cultural Appropriateness
Central Australian Aboriginal Congress (Congress) is an Aboriginal community-controlled health service, governed by a Board elected by the Aboriginal community.

For over 50 years, Congress provided health services and advocacy for Aboriginal people in the struggle for justice and equity. Since that time, Congress has developed a comprehensive, holistic and culturally-responsive primary health care service for Aboriginal people living in Mparntwe (Alice Springs), and nine remote communities: Amoonguna; Ntaria (Hermannsburg); Wallace Rockhole; Ltyentye Apurte (Santa Teresa); Utju (Areyonga); Mutitjulu; Imanpa; Kaltukatjara (Docker River); and Yulara.

Today, we are one of the most experienced Aboriginal primary health care services in the country, a strong political advocate for the health of our people, and a national leader in improving health outcomes for all First Nations.

All research carried out by Congress or in which Congress participates is approved by the Congress Board in strict accordance with the principles of Aboriginal data sovereignty and cultural responsiveness.

Objective: To synthesize the association between gestational diabetes mellitus (GDM) and adverse pregnancy outcomes among Indigenous populations globally.
Methods: A comprehensive search was conducted across five databases to identify relevant studies. Pooled risk ratios were calculated using a random-effects model, along with prediction intervals. Influence analysis, subgroup analysis, and sensitivity analysis were performed to assess study heterogeneity and individual study influence. Methodological quality was assessed using the Newcastle-Ottawa Scale, while the CONSIDER Statement was applied to evaluate the completeness of reporting in studies involving Indigenous populations.
Results: Twenty studies were included in the systematic review and meta-analysis. Pregnant women with GDM were at increased risk of caesarean section (risk ratio 1.83, 95% confidence interval 1.63–2.06; 95% prediction interval 1.40–2.39) and shoulder dystocia (3.21, 2.94–3.50; 2.63–3.92). Compared to infants of non-GDM pregnancies, those born to mothers with GDM had a higher risk of large for gestational age (2.35, 1.46–3.77; 0.64–8.65), macrosomia (1.75, 1.48–2.07; 0.95–3.22), preterm birth (1.36, 1.09–1.69; 0.77–2.38), and hypoglycaemia (8.17, 4.39–15.22; 0.68–98.66). However, they had a lower risk of low birth weight (0.80, 0.69–0.91; 0.59–1.08) and being small for gestational age (0.44, 0.39–0.50; 0.17–1.14). Four studies were classified as having a low or medium risk of bias, and 25% of studies made at least one reference to the involvement of Indigenous peoples over the course of their research.
Conclusions: This study explored the variation in outcomes within Indigenous populations globally. The findings underscore the need for culturally appropriate early GDM management and further research should focus on strong Indigenous leadership and participation in all stages of the research process, to address the health disparities affecting this population.
Keywords: Gestational diabetes mellitus; adverse pregnancy outcomes; Indigenous.


Aboriginal Governance:
This study followed Indigenous governance and ethical principles by incorporating the CONSIDER Statement – a validated tool to evaluate the completeness of reporting in studies involving Indigenous people alongside the Newcastle-Ottawa Scale in our Risk of Bias assessment, ensuring that studies were evaluated not only for methodological rigor but also for their adherence to ethical and culturally appropriate research practices.
As the first systematic review and meta-analysis on gestational diabetes mellitus and adverse pregnancy outcomes among Indigenous women, this study provides evidence to inform culturally safe care and policy interventions.
We are committed to sharing our finding with Indigenous communities and health organizations to support positive health outcomes.

Background and Aims:
Aboriginal women have been nurturing and sustaining our babies through breastfeeding for 65,000 years as an important practice for nutrition, culture, health and wellbeing. Colonisation and continuing injustices have impacted these practices for some women. We aimed to gather breastfeeding experiences and preferences for supports from Aboriginal women living on Wiradjuri Country (Wagga Wagga, NSW) to inform a community-led program.
Methods:
Part 1: A team of Aboriginal women with firsthand breastfeeding experiences used Yarning methodology to privilege the voices of 16 Aboriginal mothers and 6 Elders on key breastfeeding influences and preferences for supports. Recordings were transcribed and thematic analysis was undertaken.
Part 2: Based on the findings, a community-led breastfeeding program was designed and evaluated over 9 months with 15 Aboriginal women.
Findings:
Key themes included: the importance of intergenerational knowledge, the need for culturally responsive support, the impact of Western medicalisation on breastfeeding, and the need for additional support for mothers with pregnancy or birth complications. Participants also highlighted experiences of racism in healthcare, the importance of community-led education on breastfeeding benefits, and breastfeeding as a form of resistance and empowerment. A call for policies to support breastfeeding in workplaces and public spaces was also made. The holistic breastfeeding program's key elements will be evaluated using Indigenous evaluation methods and presented.
Conclusions:
This project highlights a breastfeeding program grounded in sovereignty and self-determination, providing valuable insights into factors influencing breastfeeding and the support preferences of Aboriginal women.

Aboriginal and Torres Strait Islander Governance:
This project upholds Indigenous data sovereignty across all aspects of the project. The project is owned and run by Riverina Medical & Dental Aboriginal Corporation (RivMed) who are the local community-controlled health service, and the administering institute. The chief investigator, project lead and all most all of the team are Aboriginal, who are mothers themselves and with first-hand breastfeeding experience. Local Aboriginal Elders were also involved in most stages of the project to provide leadership and guidance.
This project upheld Indigenous data governance through the project being governed and controlled by RivMed. This project was an important milestone towards research that is built on self-determination and sovereignty for RivMed, as the first research funding the organisation has received as the administrating institute with total control over every aspect.
The research idea was a community identified priority from local Aboriginal women working on the ground through RivMed’s antenatal service. All datasets are owned and held by RivMed to ensure data protection, integrity, confidentiality, use and accountability (data stewardship). All aspects of the project are led, designed, implemented, analysed, interpretated and translated by Aboriginal women. RivMed will use their data collected to advocate for funding, programs and policy. Ethics was granted through the Aboriginal Health and Medical Research Council of NSW HREC.

Introduction: Aboriginal and Torres Strait Islander young people are the future guardians and leaders of Country and culture, making their health and wellbeing essential. However, there are significant gaps in access and use of primary health care (PHC) among Aboriginal and Torres Strait Islander young people in Australia.

Methods: This study employed a multiphase mixed methods approach utilising Indigenous methodologies to explore how young people access, interact with, and experience PHC services. Data was gathered from young people, healthcare providers, and Aboriginal Community-Controlled Health Organisations (ACCHOs). By integrating Indigenous and non-Indigenous knowledge, the study aimed to identify opportunities to strengthen PHC services to better meet the health and wellbeing needs of Aboriginal and Torres Strait Islander youth aged 15 to 24 years living in urban southeast Queensland. The research was guided by Indigenous leadership, governance, and collaboration with Aboriginal and Torres Strait Islander young people and ACCHOs.

Results: 10 recommendations were identified across three themes that aim to strengthen PHC services for Aboriginal and Torres Strait Islander young people: 1) Strengthening the provision of PHC and the healthcare system to respond to the health and wellbeing needs of Aboriginal and Torres Strait Islander young people; 2) Improve the accountability of the healthcare system and governments to respond to the health and wellbeing needs of Aboriginal and Torres Strait Islander young people; and 3) Strengthen the capacity of Aboriginal and Torres Strait Islander young people to access PHC services. Each recommendation is accompanied by a set of actions to support the implementation of the recommendations.

Conclusion: Improving access to PHC for Aboriginal and Torres Strait Islander young people should prioritise implementing and evaluating these recommendations. By doing so, we can enhance both access to and utilisation of PHC services among Aboriginal and Torres Strait Islander young people, ultimately leading to better health and well-being outcomes.

Aboriginal Governance Structures
Continuous engagement with ACCHOs and the formation of an Aboriginal and Torres Strait Islander young people’s advisory group ensured that Indigenous leadership and governance were integral throughout this study. The study was conducted in partnership with four ACCHOs in southeast Queensland. Approval for the study was obtained from participating ACCHOs and their respective research sub-committee.

Continuously engaged throughout the research study ensured that the priorities and needs of ACCHOs and Aboriginal and Torres Strait Islander young people were central and that the research was beneficial. Specifically, ACCHOs were involved in developing and implementing the study at several stages, including the data analysis and interpretation stages, and gave final approval of the study outputs. Additionally, an advisory group comprising Aboriginal and Torres Strait Islander young people, two males and two females aged 19-24, oversaw the study. The young people’s advisory group guided the design, participant recruitment, analysis, and interpretation of research.

To support and align with Aboriginal and Torres Strait Islander governance structures, the study employed Indigenist research methodologies that prioritise Indigenous knowledge and perspectives while incorporating Western research approaches. By focusing on Indigenous ways of knowing, being, and doing, it privileges and empowers Indigenous people, particularly Aboriginal and Torres Strait Islander young people, their knowledges and experiences.