Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Yarning to inform a culturally-responsive Radiotherapy Talking Book for Aboriginal and Torres Strait Islander people undergoing radiotherapy (#34)

Bena Brown 1 2 , Haryana Dhillon 3 , michael penniment 4 , Joan Cunningham 5 , Sabe Sabesan 6 , Georgia Halkett 7 , Siddartha Baxi 8 , Adam Stoneley 9 , Giam Kar 10 , Emily Callander 11 , Joanne Shaw 12 , Sian Smith 13 , Gail Garvey 1
  1. School of Public Health, The University of Queensland, Herston, QUEENSLAND, Australia
  2. Metro South Hospital and Health Service, Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary and Preventative Health, Inala, Queensland, Australia
  3. Science, School of Psychology, The University of Sydney, Sydney, NSW, Australia
  4. Radiation Oncology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  5. Menzies School of Health Research, Melbourne, VIC, Australia
  6. Townsville Cancer Centre, Townsville Hospital and Health Service, Townsville, Queensland, Australia
  7. School of Nursing, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
  8. Radiation Oncology, GenesisCare, Gold Coast, Queensland, Australia
  9. Icon Group, Brisbane, Queensland, Australia
  10. Alan Walker Cancer Centre, NT Health, Darwin, Norther Territory, Australia
  11. School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
  12. School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
  13. Psychosocial Research Group, Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia

Objectives: Aboriginal and Torres Strait Islander (hereafter respectfully referred to as First Nations) people have higher cancer incidence and mortality rates compared to non-First Nations people1. Health communication is an integral part of delivering patient-centred care, however cross-cultural communication and differences in perspectives of health/wellbeing have been implicated in poorer cancer outcomes of First Nations people2,3. The objective was to improve clinician-patient communication during radiotherapy by adapting a Radiation Therapy Talking Book to be culturally-safe for First Nations people with cancer.

Methods: The content/design of a previously developed Radiation Therapy Talking Book4 was adapted through yarning circles with First Nations cancer patients and health professionals across three northern Australian cancer centres. Three half day consultations with Yolgnu linguists/interpreters and cross-cultural facilitators were undertaken. Further feedback was sought from First Nations community engagement. Iterative content adaptations and First Nations graphic design were undertaken. Simple English and Yolgnu Matha translation, audio recording and back-translation has been conducted using a collaborative approach with ARDS Aboriginal Corporation.

Results: Twenty-two people (21 identifying as First Nations) participated in the yarning circles, consultations or provided direct feedback regarding the content and design of the Radiation Therapy Talking Book. Feedback directly addressed content, complexity, design, format, representation of First Nations people. Participants also discussed cultural preferences related to receiving radiotherapy treatment. Yolgnu consultants discussed themes relating to First Nations knowledge, consent, pathways as a metaphor, and timing of delivery. A 45-page First Nations Radiation Therapy Talking Book has been developed in hard and soft copy, with simple English and Yolgnu Matha audio content. The book will be evaluated against usual care in late 2022.

Discussion/Conclusion: Developing a resource that addresses the priorities and needs for First Nations people undergoing cancer treatment requires building of meaningful relationships, elevating First Nations voices and flexible time commitments. 

  1. Australian Institute of Health and Welfare 2019. Cancer in Australia 2019. Cancer series no.119. Cat. no. CAN 123. Canberra: AIHW.
  2. Shahid S, et al. Barriers to participation of Aboriginal people in cancer care: communication in the hospital setting. Med J Aust 2009; 190(10): 574-9.
  3. Olver I, Gunn KM, Chong A, Knott V, Sprong K, Cominos N, Cunningham J (2021). Communicating cancer and its treatment to Australian Aboriginal and Torres Strait Islander patients with cancer: a qualitative study. Supportive Care in Cancer, org/10.1007/s00520-021-06430-3
  4. Smith SK, Cabrera-Aguas M, Shaw J, Shepherd H, Naehrig D, Meiser B, Jackson M, Saade G, Bucci J, Halkett GKB, Turner RM, Milross C, Dhillon HM. A low literacy targeted talking book about radiation therapy for cancer: development and acceptability. Support Care Cancer. 2019 Jun;27(6):2057-2067. doi: 10.1007/s00520-018-4446-0. Epub 2018 Sep 17. PMID: 30225574.