Dr Joanne Luke

Abstract

Australian governments and universities are increasingly promoting evidence-based practice in Aboriginal and Torres Strait Islander settings. This practice has meant that Western evaluation and research ‘evidence’ is increasingly being applied to decision making in this setting.

In recent years Indigenous scholars and communities have come to question the ethics of applying evidence-based practice within Aboriginal and Torres Strait Islander settings. Firstly, they raise concerns regarding the quality, ethical strength, and safety of the existing evidence-base, especially given the long and tarnished history of “dirty” research on Aboriginal and Torres Strait Islander people. Secondly, they express issue with contemporary Western evidence-based practice methods (including evidence hierarchies, tools and guidelines) which all privilege Western ‘evidence’ which can marginalize the expert perspectives, experiences and knowledge of Aboriginal and Torres Strait Islander community controlled organisations.

In this thesis, a critical Indigenous research methodology was applied to better understand the existing evidence-base (research and evaluation) and evidence-based practice relating to Aboriginal and Torres Strait Islander people. This thesis is presented in three sections:

Past
In Australia, dominant universities such as the University of Melbourne have long been the sites of colonising knowledge production practices where research and evaluations have been constructed without consent, benefit or involvement through methodologies “about us, without us”. Masquerading as ‘evidence’ these knowledges have provided the logic for many social policies that have had real and devastating impacts. This review rather than focusing upon what is known about Aboriginal and Torres Strait Islander bodies, turns the gaze on research ‘experts’.  Focusing on researchers from the University of Melbourne, this review describes past research methodologies and the resulting research ‘evidence’. In examining past research, this review brings attention to the everchanging socio-cultural context of research and reflects on the role that ethical reform and Aboriginal and Torres Strait Islander peoples’ self-determination has played in changing research practice and generating more ‘culturally informed evidence’.

Present
Research has changed dramatically with the establishment of global and national ethical reforms and guidelines. However, the contemporary public health environment is still largely characterised by an environment where qualified ‘experts’ in Australian universities and governments are powered to construct research and evaluation ‘evidence’ about Aboriginal and Torres Strait Islander people using Western research and evaluation methodologies.

This section consists of three publications that evaluate and critique contemporary public health practice. These publications highlight issues with the availability, quality and ethical strength of existing research and evaluation ‘evidence’ relating to Aboriginal and Torres Strait Islander people. This research also identifies concerns with contemporary evidence-based practice environments where Western ‘experts’ and western practice methods are valued.

Future
In this section, I present an Aboriginal-led epidemiological analysis, where the knowledges and experience of the community controlled sector contributed to the construction of culturally informed evidence. In this section, I also consider future public health practice, arguing that building a culturally informed evidence base and the enaction of culturally informed evidence-based practice will require Aboriginal and Torres Strait Islander people and organisations to have greater control in public health decision making.

Supervisors

• Professor Sandra Eades AO (principle)
• Professor Margaret Kelaher, Centre for Health Policy (co-supervisor)
• Professor David Thomas, Menzies School of Health Research (co-supervisor)

School

Centre for Health Equity, School of Population  and Global Health

Read the thesis