Enhancing Indigenous Capacity: Building a Sustainable Future: a national symposium on workforce development in Indigenous maternal and child health

Kulunga Conference 2007 Kulunga Conference 2007 Kulunga Conference 2007

The national symposium Enhancing Indigenous Capacity: Building a Sustainable Future was held in Perth , Western Australia , 8-9 May 2007. The symposium was hosted and supported by the Rio Tinto Child Health Partnership and sponsored by the Australian Government Department of Health and Ageing.

The major aims of the symposium were to:

  • enable a range of stakeholders from across Australia to share their expertise, experiences, research and resources;
  • identify clear directions and strategies at both a practical and policy level for enhancing the skills of the Indigenous health workforce, increasing the number of health workers in Indigenous communities and improving the coordination and delivery of primary health care services to Indigenous people; and
  • provide health workers with resources to assist them to address maternal alcohol and tobacco use in Indigenous communities.

The symposium examined issues central to the development of the maternal and child health workforce in Indigenous communities, including how to:

  • build the child and maternal health skills of health workers in Indigenous communities;
  • increase the number of Indigenous health workers and enhance training and accreditation so they can deliver comprehensive and holistic primary health care; and
  • coordinate service delivery across government agencies and the community controlled sector to improve Indigenous peoples access to and utilisation of services.

The proceedings started with a welcome to country by Noongar Elder, Vivienne Hansen. The opening address was by Professor Fiona Stanley, Director of the Telethon Institute for Child Health Research and Chair of the National Advisory Committee, Rio Tinto Child Health Partnership.

The International Keynote address was presented by:

  • Dr Janet Smylie, Associate Professor, Department of Public Health Sciences at the University of Toronto and research scientist at St Michael’s Hospital at the Centre for Research on Inner City Health – Kokum, what makes baby well?

Other keynote addresses were presented by:

  • Dr Kathryn Panaretto, Medical Director at the Townsville Aboriginal and Islander Health Services – The Mums and Babies Program
  • Donna Ah Chee, Deputy Director Central Australian Aboriginal Congress – The development of the maternal and child health program
  • Sandra Collard, Workforce Issues Project, Aboriginal Health Council of Western Australia – The workforce issues project at the Aboriginal Health Council of Western Australia
  • Associate Professor Ted Wilkes, Rio Tinto Child Health Partnership Leader – Aboriginal health: the male perspective
  • Dr Kathryn Panaretto, Medical Director at the Townsville Aboriginal and Islander Health Services – The development and implementation of a randomised controlled trial of a culturally specific intervention for pregnant women who smoke

The forum included four workshops:

  • Empowerment, Indigenous men’s groups and social and emotional wellbeing: implications for workforce development
  • Enhancing the capacity to reduce smoking in Aboriginal communities
  • Alcohol and pregnancy: health professionals making a difference
  • A community controlled approach to reducing the risk of SIDS in Aboriginal communities

Australian Indigenous HealthInfoNet staff Sam Burrow, Sharon Clews, Ineke Krom and Annemarie Paddick ran a HealthInternet café at the symposium.

  • For further information regarding the symposium contact:

We’d like to thank the symposium participants who provided written permission for us to display their photos here (click on the photos to enlarge).

Links to Australian Government Budget 2007-08: information of relevance to Indigenous health

Federal Treasurer Peter Costello delivered his twelfth Australian Government Budget on Tuesday evening, 8 May 2007. The following links provide information on the Budget and its implications for Indigenous health.

Indigenous Affairs Budget 2007-08

The Australian Government Indigenous Affairs Budget 2007-08 provides information on Indigenous spending across all Government portfolios.
View Indigenous Budget 2007-08 contents web page
View document (PDF – 2.28MB – large file warning!) – includes media releases and fact sheets on individual measures
View summary of Indigenous measures (PDF – 266KB)

Portfolio Budget Statements 2007-08

More detailed information on various components of Indigenous expenditure is available in the respective Portfolio Budget Statements 2007-08, including the:

Health and Ageing Portfolio

Portfolio Budget Statements 2007-08
View document (PDF – 2.67MB – large file warning!)
Outcome 8 – Indigenous health is downloadable separately.
View document (PDF – 72KB)
View document (RTF – 328KB)

Health and Ageing Budget at a glance provides a statistical summary of expenditure
View information (HTML)

Families, Community Services and Indigenous Affairs Portfolio

Portfolio Budget Statements 2007-08
View document (HTML)

Full Budget details

Full Australian Government Budget details are available at the official Australian Government Budget website.
View website

Other media releases

Study shows that Indigenous Australians are not genetically prone to diabetes

The following information has been adapted from information provided by Menzies School of Health Research and the ABC.

A recent study from Menzies School of Health Research has found that Indigenous Australians are not genetically prone to diabetes. The study was authored by epidemiologist Yin Paradies, along with two researchers from the United States. It shows that the high rates of diabetes among indigenous people across the globe are rooted in social disadvantage rather than a genetic predisposition specific to indigenous populations.

It has previously been thought that high rates of diabetes among Indigenous Australians and other indigenous populations were partly attributable to a ‘thrifty genotype’ that is very efficient at using nutrients. Globally, rates of diabetes are around 2-5 times higher among indigenous people.

Paradies believes the most important way to tackle diabetes in Indigenous Australians is through addressing social disadvantage.

Reference details and links to the published findings are below:

Paradies YC, Montoya MJ, Fullerton SM (2007)
Racialized genetics and the study of complex diseases: the thrifty genotype revisited.
Perspectives in Biology and Medicine
;50(2):203-227
View article: Perspectives in Biology and Medicine (HTML)
View article: Perspectives in Biology and Medicine (PDF – 144KB)
View website: Project Muse

Aboriginal and Torres Strait Islander kids and bikes: socio-cultural factors and safety

Malcolm Vick

View PDF

Abstract

Objective: The study sought to document young Indigenous people’s bike riding practices, explore cultural factors shaping those practices and consider ways those practices might put them at risk.
Methods: Ninety five Townsville Aboriginal and Torres Strait Islander school students participated in face to face interviews or focus groups, and completed quizzes and questionnaires on their bike riding behaviour, knowledge of road rules, and bike safety issues; the study was conducted in 2000.

Results: Indigenous young people are frequent bike users in a wide range of contexts. They demonstrate sound knowledge of road rules, but largely ignore many of them. Different aspects of their riding are shaped by mixes of poverty, sense of obligation, pragmatism, and style. They identify and act on safety issues only in relation to other road users’ behaviour, including normal conditions of road use (e.g., closeness of cars on busy roads), racist driver aggression, and ‘social’ danger from police.

Conclusions: Young Indigenous cyclists’ riding practices appear broadly consistent with practices documented among other social groups, and put them at risk of injury, although they widely adopt practices to minimise danger from other road users. Racism, and their visibility, makes them a target for harassment that also puts them at risk. They do not, however, understand road use in terms of risk and the study highlights complex cultural factors shaping their decision making as cyclists.

Implications: Young Indigenous cyclists’ own behaviour might be addressed by a combination of education and enforcement regarding safer riding practices, within and by Indigenous communities and families. Securing their safety also requires racist aggression by non-Indigenous road users, and police relationships with Indigenous people to be addressed.

Suggested citation: Vick M (2007) Aboriginal and Torres Strait Islander kids and bikes: socio-cultural factors and safety. Australian Indigenous HealthBulletin;7(2): Original article 1. Retrieved [access date] from http://www.healthinfonet.ecu.edu.au/html/html_bulletin/bull72/original_articles/bulletin_original_articles_vick.htm

Introduction

Aboriginal and Torres Strait Islander people are high-risk road users as demonstrated in their heavy over-representation in Australian road trauma statistics [1,2]. Further, their involvement is almost certainly under-reported [3,4]. Young people can also be seen to be especially at risk for essentially developmental reasons. There is almost no published research on safety issues for young Indigenous bike riders, although there is data on Aboriginal children’s helmet wearing [5], on levels of exposure and involvement in crashes of young cyclists more generally [6], and on the significance of Indigenous young people’s bike riding as a safety issue [4]. This paper addresses the lack of research on this issue through a small scale study in Townsville, where Indigenous people are a significant and visible minority (5.1% of total population) [7].

Much bicycle safety research focuses on the incidence, nature and severity of crashes and injuries [8,9,10,11], on contributing factors ranging from environmental and other ‘external’ factors [12,13], and the relations between the introduction, and encouragement or enforcement of protective measures (e.g., helmet legislation), cyclists’ responses to such protective measures (e.g., greater risk-taking), and the safety outcomes of those measures [14,15,16,17,18,19,20,21,22,23]. Some studies seek to explain as well as to document cyclists’ behaviour. Some focus, especially in the case of younger children, on developmental factors, such as the ways limited cognitive and motor skills and experience affect their awareness and their capacities to judge, make decisions and execute those decisions [24,25]. Others focus on social factors such as socioeconomic background, gender, parental intervention, and early experiences with alcohol [26,27,28,29,30], and on social-psychological factors such as susceptibility to peer pressure, identity and image [15]. Characteristically, reasons for behaviour remain relatively unexplored, and are attributed to presumed universal psychological characteristics of adolescents or treated very superficially [26,27,28,29]; thus, children’s explanation of their aversion to helmets because they are ‘silly, uncomfortable, or inconvenient’ [27, p.220] is accepted at face value without exploring further the array of meanings and values – the cultural contexts – which inform such judgments.

In contrast with these approaches, and to address these limitations in existing research, this study takes a sociological approach, in line with the Australian Transport Safety Board’s recommendations [3] concerning the need to ‘research historical and cultural factors influencing beliefs and perceptions about health and injury; and develop protocols for undertaking research in indigenous communities’ (p.233). In this case, the social-contextual factors include the contexts and conditions of bike riding, while more cultural factors include the meanings and values that Indigenous young people draw on in relation to bike riding and the situations that accompany it. In general terms, it builds on approaches to socio-cultural factors shaping road use developed in work by Connell [31,32], Natalier [33], Redshaw [34], Vick [35] and Walker and colleagues [36] and applies these in the particular context of Indigenous young people’s bike use.

Methods and approach

The study involved 95 Aboriginal and Torres Strait Islander students in Townsville. Participants were aged between 9 and 16 years, and comprised 36 male and 42 female primary students; and 9 male and 18 female secondary students. The study, while initiated by the author as a non-Indigenous academic researcher, drew on support from local Indigenous organizations, in keeping with established principles for research involving Indigenous communities [37,38]. The project was primarily concerned with providing a basis for more effective responses to what representatives of some key Indigenous community organisations saw as high levels of risk to their young people associated with their use of bikes. However, theorisation of the data formed an important part of generating the ‘useful knowledge’ we sought.

The project relied heavily on input from Indigenous research assistants and advisers. Broad parameters for the research were established through consultation and negotiation between the researcher, research team and community advisers. The specific methods were largely developed and wholly executed by a small team of Indigenous researchers, under leadership of an Indigenous project officer, to ensure that the research was culturally sensitive and appropriate.

The students from whom data were gathered were informed of the project through Indigenous support programs and staff in Townsville primary and secondary schools, and volunteered to take part in it. In order to protect them from any possible adverse consequences of what they had to say, and with a view to using this security to encourage them to speak freely, they were never identified by their own names, but participated under pseudonyms of their own choosing. Research ‘sessions’ were held at school during lunch break, and students’ loss of free time was compensated by provision of lunch (pizza, garlic bread and soft drink), and ‘sample bags’ of stickers and other ephemera donated by the local Department of Transport office, businesses, and professional sporting clubs.

Focus groups and semi-structured individual interviews provided the major means for eliciting qualitative data. The decision to use both forms of interview was dictated by the need to interview all students who volunteered, with limited time available in each school, but also reflected the recognition that focus groups and individual interviews are generate somewhat different data. On the one hand, focus group data may suffer from a degree of distortion of some individuals’ views as dominant voices shape a ‘consensus’ view. On the other, they, offer both a sense of the complexity of views, especially on contentious issues, and of the strength of consensus on others [39].

Both individual and group interviews sought to elicit free-ranging discussion of participants’ experiences, attitudes and values, and matters of concern. Quizzes about knowledge of road rules and their application were conducted orally as the first part of the interviews. Students were also asked to complete questionnaires, which sought details of bike use, including frequency, social context, condition of bike most usually ridden, access to helmet, and safety precautions. A quantitative account of the findings and related methodological issues has been presented elsewhere [40]. Here, I am concerned with the qualitative data for the light it sheds on broadly cultural factors shaping their bike use.

Results

Why they ride

Bike riding figured prominently in participants’ lives. They reported using their bikes for a variety of purposes including going to school, other ‘functional’ purposes (going to the shop); family related activities (‘errands’/‘doing a favour for family members’), recreational and social activities (doing things with, or visiting, friends, or simply as a recreation in itself) and for exercise. Around half claimed that bikes were their main mode of transport.

Knowing and doing

Most demonstrated a sound basic knowledge of road rules, including road signs, traffic lights, and laws governing helmet use and doubling. There were some important gaps in their knowledge, however, and most were unsure of proper procedure at roundabouts. Whatever their detailed knowledge of the road rules, they virtually all recognised that the rules applied to all road users, including themselves as bike riders.
‘Knowing’ often did not translate into ‘doing’. A substantial proportion either stated straight out that they knew but did not follow the rules, or that they did so only sometimes; others demonstrated in their answers to a range of questions about their actual road use that they did not comply. Younger children claimed to regularly obey traffic lights and stop signs, while older students said they did so ‘sometimes’ and ‘never’.

‘Doubling’ and pragmatism

An overwhelming proportion of the students said that they knew doubling was illegal. Yet almost all of them admitted to participating in doubling (two or more children on one bike). Younger ones were more often passengers than ‘doublers’; older ones did both. Both sexes were involved, although the proportion of males was higher. Many of the younger students said they did not double because their parents did not allow them to, or because they did not have the skill.

Most recognized that doubling could be dangerous, but about half of them said that it was only dangerous ‘if you don’t do it properly’. In other words, safety depended on skill.

Given established research findings about young people and risk-taking, and the widely admitted hostility between Indigenous young people and police, authority and the law, we had anticipated that both these would come into play as explanations for their behaviour. We were wrong. Instead, what came through in the students’ comments was a straightforward practicality. The following were typical of their responses to the question ‘Why do you or your friends double?’: ‘To get somebody to place to place’; ‘When I wear no shoes I get doubled’; ‘So we get to places faster’; ‘Cos they haven’t got a bike’; ‘If we don’t have transport’; and ‘Because it’s faster than walking together’. Their practicality seems to reflect both the depressed financial position of large numbers of Indigenous families, and the high value placed on personal loyalties and obligations (not to leave a friend or relative to walk, for instance).

Helmets and ‘cool’

Many of the students, especially those at primary school, claimed that they consistently wore a helmet. Most of the older ones stated that while they owned or had access to a helmet, they wore it sometimes but preferred not to. When asked why they, or others, might wear a helmet, the most common response across all ages was ‘because I have to’. Fewer, but a still substantial proportion, said they did so because of the risk of injury, or ‘to protect my head’, while the next most common response was that it was legally required, and that not to wear one was to risk drawing police attention. Very few said that peer pressure (‘my friends tell me to’) and peer practice (‘because my friends do’) influenced their decision to wear helmets.

While many said they wore their helmets more or less regularly, they clearly did not like wearing them. Some expressed this in strong but general terms, with comments such as ‘well it’s just f***ed’. Most explained it more specifically in terms of style: ‘they’re ugly’, ‘you look like a loser’, and ‘it’s not cool’. A high proportion of girls (no boys!) added comments such as ‘it messes up my hair’. Others offered practical explanations, such as that that ‘they’re hot’, or that they didn’t have access to one. Many also stated that they did not wear helmets because they did not think they were necessary: ‘I don’t expect to get hurt’.

Whereas doubling seems to be a fairly simple, practical matter for them, helmet-wearing appears to be a more complex issue. Their dislike of helmets because they are hot can be seen as pragmatic: for much of the year temperatures and humidity are oppressively and relentlessly high, and even in winter daytime temperatures are often in the high 20s. The unavailability of helmets for some can be seen as a socio-economically imposed practical factor, quite independent of any personal values related to helmet-wearing choice. Relations with authority are also important, and combine pragmatism (a practical submission to family discipline, and a fear of getting fined) with more abstract symbolic values (respect for both parents and to a significantly lesser degree, the law), although both of these lose force with the transition from childhood to adolescence, and have less effect with males than with females. As with doubling, physical safety barely enters as an issue. The crucial issue, however, is style, and their references to ‘cool’ resonate with Dawes’s [41] observations about Indigenous young people’s take up of ‘American’ youth-cultural styles. This is a reminder of the complexity of cultural factors, blending distinctive practices from within the Indigenous communities with influences made available through the mass media.

Safe riders vs good riders

Most claimed to be safe riders. The majority of those who did not, said that they simply had not thought about the issue. Almost none said they considered themselves an unsafe rider. Some aspects of their knowledge and self-reported behaviour (e.g., their knowledge of and claimed compliance with traffic signs and lights) support their claims. Other considerations, such as the incidence of doubling, and their privileging of style over safety considerations in relation to helmets, point in the opposite direction.

Their responses to questions about what constitutes a ‘good’ rider made few direct connections to safety. Many of the female interviewees talked about ‘good riding’ in terms of what might be described as ‘functional skill’: being able to control a bike, to react to unexpected circumstances, and the like. While not couched in terms of safety, these accounts of good riding can be seen as compatible with, if not sufficient for ensuring safety. But for most of the boys, good riding appears to be quite disconnected from considerations of safety. Rather, they described a range of high-level skills, coupled to notions of risk, bravado and being ‘deadly’. Indeed, the stories they told in relation to ‘good riding’ involved running red lights, jumping gutters and other manoeuvres, or performing other feats, or successfully managing unexpected gravel patches. It was not so much that safety considerations were dismissed, or subordinated to other concerns; rather, they simply did not enter the picture. At the same time, and in contrast to some accepted views about risk-taking as something valued in itself by adolescents [42], there was no sense that those interviewed valued risk for its own sake; rather, the risk was simply a by-product of pushing skill to its limits.

Police and the law

We asked about their experiences and attitudes in relation to the law and the police, carefully framing questions in neutral terms, and starting with simple factual matters such as whether they had ever been stopped, and why, before asking about their thoughts and feelings about the incident. Well over half, including a substantial minority of younger participants, reported having been stopped, mainly for not wearing helmets.
The older boys, especially, expressed a strong sense of hostility to, and contempt for, the police. It is noteworthy that with only a handful of exceptions, this was the only context where the students used ‘strong language’: for several, police were ‘F***’n cops’; others commented that they ‘hated’ police while one young boy said, ‘they are stupid and they suck’.

Their comments on particular experiences with police ranged from the emotionally charged ‘I was a bit afraid’, through ‘I felt bad’, ‘I thought I was in a alien world’, and ‘I was shame’, to the more pragmatic and strategic ‘I should of taken the back streets’. Here, consistently with the reasons they had given earlier for wearing helmets, almost half the younger ones said that being stopped had been effective in encouraging them to take up wearing their helmets (‘don’t want to be caught again’). Most of the older ones, however, suggested that the effect had been, rather, to encourage them to take less conspicuous routes or, in a few case, to take flight more quickly. A handful simply expressed contempt for the whole process: ‘who gives a f***’.

Particularly noteworthy, here, is the disconnection of the attitudes expressed in the context of immediate, face-to-face interaction with police, from those expressed elsewhere – intensity and hostility in one instance, low-key and unemotional in the other. For the most part, then, police and the laws they represent are a relatively insignificant, marginal consideration shaping their bike riding, but when they enter the picture more directly, the interactions appear highly flammable.

Respondents raised two issues which we had not included in our list of matters to raise, but which have a bearing on the connection between road safety and wider social concerns. Some of the older participants, including some of the girls, claimed that as ‘black kids’, they felt singled out for attention by police, either because they were ‘black’ per se, or because they were already ‘known’ (which some of them saw as a further result of ‘being black’). Some also related occasions when, having attracted police attention for some bike-related matter, they were then ‘asked all these dumb questions’: ‘Aren’t you so and so’s brother…’, ‘Weren’t you at…?’, and ‘What can you tell me about…?’ They placed such attention in the context of continuing tensions between ‘black’ youths (and the Indigenous community generally) and police, a view supported by a range of public comments and reports by Indigenous leaders and outside observers [43,44].

Dangerously significant others

While their responses across the various forms of data show little connection between their behaviour and considerations of safety, many of them did indicate a sense of danger from others. A very high proportion of younger respondents, for instance, said that they habitually rode on the footpath because of the danger from cars and other vehicles. Most had stories of incidents – some relatively serious – which entailed physical danger or harm: encounters with car doors, or vehicles reversing from driveways. From their accounts, it seems highly likely that such incidents are very substantially under-reported.

Among older participants there was a thread of commentary, supported by stories of particular incidents, which suggested that roads are dangerous for Aboriginal and Torres Strait Islander youth for social – racist – reasons, as distinct from what might be thought of as road-, traffic- or driving-related factors. Many spoke of being harassed verbally by drivers or other occupants of passing cars. One wrote, ‘I’ve seen drivers swerve at black kids’, and others related similar experiences.

Their comments appear to be borne out by the flurry of public discussion which followed an incident in which a young man deliberately drove his car into a 15 year old Aboriginal boy riding with a group of friends [45,46]. The incident produced further stories from members of local Indigenous communities about other incidents in which ‘white’ youths used motor cycles and motor cars to threaten and attack Indigenous young people, and claims that they formed part of ongoing racist harassment in the city [44].

Conclusions

The data suggest that for the young people who contributed to this study, bike riding involves an array of risks, from their own behaviour, the normal conditions of road use, and from the hostile behaviour of others. Equally, safety appears to be a relatively marginal concern for these young people. Even where they do recognize that there might be dangers, they see them as arising from the actions of others, overlooking the ways in which their own riding practices are unsafe. Importantly, they associate ‘good’ riding with potentially high-risk demonstrations of ‘deadly’ skill rather than with ‘safe’ riding.

The findings are broadly consistent with those of other relevant studies. In particular, the interview data are consistent with findings that crashes involving Indigenous road users in general, and Indigenous cyclists in particular, are under-reported [4,6, pp.6-7,47], that Indigenous children and adolescents are highly exposed to risk (6, p.8). They are also broadly consistent with findings of many studies in non-Australian and non-Indigenous Australian contexts that there is a widespread aversion to wearing helmets and that wearing them is related to gender, age, economic circumstance and parental pressure [15,29].

There findings here differ from existing studies in two significant ways. First, while many studies of helmet wearing identifies calculations of risk as a significant factor the data here reveal almost nothing that could be interpreted as an awareness, much less a calculation, of risk [20]. Rather, behaviour appears to be shaped either by purely pragmatic considerations, framed within a culturally informed understanding of social relationship and obligation. This attention to reasons and their cultural significance constitutes the second major difference from the findings of existing studies. Where existing literature attributes behaviour to presumed universal psychological characteristics of adolescents or accepts reasons given for behaviour at face value [27,28], the findings here indicate that behaviour is shaped through the ways situations are interpreted and meanings attached to actions. The fact that those interviewed drew on values and language which appear distinctively Indigenous (e.g., ‘shame’) and also on values and language which are clearly shared with non-Indigenous young people (‘uncool’) points to the complexity of the cultural factors involved.

Implications

The tendency to attribute danger to the action of others, to separate routine behaviours of convenience and obligation, such as doubling, from questions of safety, and their association of good riding with risk taking could usefully be taken into account in planning road safety interventions. The social contexts, including the clearly expressed sense of hostility between many of our adolescent participants and figures of ‘white’ authority suggest that it is important that such interventions be seen to emanate from within the Indigenous community itself, and that careful consideration be given to methods of policing. Their accounts of racist aggression on the roads (and other evidence of this) suggest the importance of addressing this issue at the level of both education and policing. Finally, the almost complete absence of detailed research about Indigenous young people’s bicycle riding, the incidence and severity of crashes involving young Indigenous cyclists and the significance of cultural factors in shaping the understandings underlying decision-making on the road identified here all point to the need for further research in this area.

Acknowledgements

This study was funded by a grant from the Centre for Accident Research and Road Safety, Queensland (CARRS-Q) at the Queensland University of Technology.

Indigenous people who contributed to the development and carrying out of the project included Rachel Atkinson, Deb Alvoen, Andrea Geary, Jeannie Herbert, Winnunga Koorine, Leah Morris, Jeremy Pau, Ralph Rigby and Val Stanley.

Contact details

Associate Professor Malcolm Vick, Director of Research, School of Education, James Cook University, Townsville QLD 4811, Australia, ph: (07) 4781 4229, email: Malcolm.vick@jcu.edu.au

References

1 Cercarelli L R (1994) Road Crashes Involving Aboriginal People in Western Australia. Accident Analysis and Prevention; 26(3):361-369
2 Cercarelli R, Knuiman M (2002) Trends in road injury hospitalisation rates for Aboriginal and non-Aboriginal People in Western Australia. Injury Prevention; 8(3):211-215
3 Australian Transport Safety Board (2004) Road safety in Australia: a publication commemorating World Health Day 2004. Canberra: ATSB
4 Styles T, Edmonston C (2005) Australian Indigenous Road Safety 2005 Update. Road Safety Research Report CR225. Canberra: Australian Transport Safety Bureau
5 Thomas H, Somers R L, Anderson R W G (2004) South Australian primary schools bicycle helmet usage survey. CASR Report Series CASR06. Adelaide: Centre for Automotive Safety Research.
6 Legge M, Williams H A, Cercarelli R (2006) Reported Road Crashes in Western Australia 2003. Perth: Road Safety Council of Western Australia
7 Townsville City Council (2003) The Townsville region: a social atlas 5th edition. Retrieved 19 September 2004 from http://www.townsville.qld.gov.au/about/atlas/analysis_02.asp
8 Attewell, R, Glase K, McFadden M (2000) Bicycle helmets and injury prevention. A formal review. Canberra: ATSB
9 Cook A, Sheikh A (2003) Trends in serious head injuries among English cyclists and pedestrians. Injury Prevention; 9(3):266-267
10 Thompson M, Rivara P (2001) Bicycle-related injuries. American Family Physician; 63(10):2007-14, 2017-18
11 N. Meuleners L B, Gavin A L, Cercarellia L R, Hendrie D (2003) Bicycle Crashes and Injuries in Western Australia, 1987-2000. Perth: Injury Research Centre, School of Population Health, University of Western Australia.
12 Reading R (2004) Bicycle helmet campaigns and head injuries among children: Does poverty matter? Child: Care, Health and Development; 30(1):89
13 Legg S, Laurs E, Hedderley D (2003) How safe is cycling with a schoolbag? Ergonomics; 46(8):859-869
14 Adams J, Hilman M (2001) Bicycle helmets. Risk taking is influenced by people’s perception of safety and danger. British Medical Journal; 322(7293):1063
15 Finch C F (1996) Teenagers’ attitudes towards bicycle helmets three years after the introduction of mandatory wearing. Injury Prevention; 2(2):126-130
16 Grant D, Rutner S (2004) The effect of bicycle helmet legislation on bicycling fatalities. Journal of Policy Analysis and Management; 23(3):595-612
17 Ivett L (2001) The role of parents/carers in the road safety education of children and youth. Retrieved 3 October 2002 from http://www.Officeofroadsafety.wa.gov.au/Facts/papers_2001/paper_8/paper8.pdf
18 Karkhaneh M, Kalenga J-C, Hagel B E, Rowe B H (2006) Effectiveness of bicycle helmet legislation to increase helmet use: a systematic review. Injury Prevention; 12(2):76-82
19 Kendrick D, Royal, S (2004) Cycle helmet ownership and use; a cluster randomised controlled trial in primary school children in deprived areas. Archives of Disease in Childhood; 89(4):330-335
20 Lardelli-Claret P, de Dios Luna-del-Castillo J, Jiménez-Moleón J, García-Martín M, et al. (2003) Risk compensation theory and voluntary helmet use by cyclists in Spain. Injury Prevention; 9(2):128–132
21 Parkinson G, Hike K (2003) Bicycle helmet assessment during well visits reveals severe shortcomings in condition and fit. Pediatrics; 122(2):320-3
22 Reading R (2003) The efficacy of bicycle helmets against brain injury. Child: Care, Health and Development; 29(3):226
23 Thompson D, Thompson R, Rivara, F (2001) Risk compensation theory should be subject to systematic reviews of the scientific evidence. Injury Prevention; 7(2):86-88
24 Ampofo-Boateng K, Thomson J (1991) Children’s perception of safety and danger on the road. British Journal of Psychology; 82(4):487-505
25 Maring W, van Schagen I (1990) Age dependence of attitudes and knowledge in cyclists. Accident Analysis and Prevention; 22(2):127-136
26 Berg P, Westerling R (2001) Bicycle helmet use among schoolchildren—the influence of parental involvement and children’s attitudes. Injury Prevention; 7(3):218-222
27 Khambalia A, MacArthur C, Parkin P C (2005) Peer and adult companion helmet use is associated with bicycle helmet use by children. Pediatrics; 116(4):939-942
28 Klein K S, Thompson D, Scheidt P C, Overpeck M D, Gross L A (2005) Factors associated with bicycle helmet use among young adolescents in a multinational sample. Injury Prevention; 11(5):288-293
29 Macpherson A K, Macarthur C, To T M, Chipman M L, Wright J G, Parkin P C (2006) Economic disparity in bicycle helmet use by children six years after the introduction of legislation. Injury Prevention; 12(4):231-235.
30 Parliamentary Travelsafe Committee (2003) Reducing the road toll for young Queenslanders – is education enough? Report No. 40. Brisbane: Legislative Assembly of Queensland
31 Connell R (1995) Masculinities. St Leonards, NSW, Allen and Unwin
32 Connell R (2001) Studying men and masculinity. Resources for Feminist Research; 28(1-2): 43-57
33 Natalier K (2001) Motorcyclists’ interpretations of risk and hazard. Journal of Sociology; 37(1):65-80
34 Redshaw S (2001) Changing driving behaviour a cultural approach. Australian Journal of Social Issues;36(4):315-331
35 Vick M (2003) Danger on the roads! Masculinity, the car, and safety. Youth Studies Australia; 21(1):32-37
36 Walker L, Butland D, Connell R (2000) Boys on the road: masculinities, car culture, and road safety education. Journal of Men’s Studies; 8(2):153-169
37 National Medical and Health Research Council (2003) Values and ethics: guidelines for ethical conduct in Aboriginal and Torres Strait Islander health research.Canberra: Commonwealth of Australia
38 Australian Institute of Aboriginal and Torres Strait Islander Studies (2000) Guidelines for ethical research in Indigenous studies. Canberra: AIATSIS.
39 Litosseliti L (2003). Using Focus Groups in Research. Continuum: New York
40 Vick M (2005) Indigenous youth, bikes and safety. Journal of the Australasian College of Road Safety; 16(1):29-35
41 Dawes G (1998) Break on through: Indigenous youth subcultures and education. Townsville: Centre for Social Research, James Cook University
42 Bradley G, Matsukis P (2000) Identity status and youth recklessness. Youth Studies Australia; 19(4):48-53
43 Ingram K (2003) Indigenous people ‘shot with flare guns, bashed’. Townsville Bulletin; 27 June:6
44 Seeney H (2003) Racial tensions rising. Townsville Bulletin; 13 June:1
45 Seeney H (2003) Cyclist, 15, killed. Man to front court on driving charge. Townsville Bulletin; 9 June:3
46 Stockdale K (2004) Lives ruined. The Wyles death case – what the judge said. Townsville Bulletin; 27 March:1-3