Dalki Garringa (Good Growing): Co-creating Evidence to Support the Healthy Growth of Children and Improving Food Security Among Aboriginal and Torres Strait Islander Communities in Non-remote Areas of Australia

Abstract

Having a healthy weight in childhood and food security are both vital for the lifelong health and wellbeing of Aboriginal peoples. This thesis aimed to describe the influences driving food insecurity, and the prevalence and factors associated with healthy weight among Aboriginal children and families in non-remote areas, and an effective model of co-creating research.

This thesis used mixed methods, combining quantitative analyses of baseline and linked data from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH) and two qualitative studies using semi-structured interviews.

Most Aboriginal children in SEARCH had a healthy weight, but there were decreasing trends from early childhood at around 6 years of age. Healthy weight was associated with lower waist:height ratio, having a caregiver with healthy weight, being physically active, and waiting ≥6 months of age before introducing solid foods.

Nine key factors for co-creation were described: shared control; strong credible leadership; shared vision, shared goals; willingness to take risks; connecting across cultures; empowering the community; valuing local Aboriginal knowledge; ongoing investment and collaboration; and adaptability. Five complex drivers of food insecurity were identified: being trapped in financial disadvantage; gaps in the local food system; limitations of non-Aboriginal food relief services; ongoing effects of colonisation; and maintaining family, cultural and community commitments and responsibilities.

Food insecurity and weight status are driven by a range of socioeconomic, environmental, and systemic factors. These findings highlight the need for system-level changes in the food environment, along with ensuring Aboriginal knowledges and cultures inform the development of programs and policies targeting food security and child weight status. Co-creation of research is vital to ensure the translation of findings to support positive health outcomes for Aboriginal peoples.