coming to an ethics of research practice in a remote aboriginal australian community

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Copyright © eContent Management Pty Ltd. Contemporary Nurse (2013) 46(1): 18–27.

Researchers working with Aboriginal Australian communities are inherently faced with a range

of unique historical, socio-cultural and political complexities that challenge conventional research approaches (Bainbridge, Whiteside, & McCalman, 2013). Undertaking palliative care research with Aboriginal Australians in a remote setting is even more demanding. Regardless of whether the researcher is located within or outside their cultural environments, or using amenable methodologi-cal approaches, practice imperatives are ampli-fied in such complicated and sensitive contexts (Bainbridge, Whiteside, et al., 2013). Processes aimed at promoting research to meet the aspirations of Aboriginal Australians have long been advo-cated locally and globally by Indigenous scholars and communities; and funding bodies have devel-oped research frameworks to uphold such prac-tices. These ethical practice principles have been advanced in research institutions, and community-based participatory research approaches recognised as important for improving policy-making, health care and health outcomes for Aboriginal Australians at regional and national levels. But there is negli-gible documentation in the health literature about

Coming to an ethics of research practice in a remote Aboriginal Australian community

ROXANNE BAINBRIDGE*, KOMLA TSEY+, CATHERINE BROWN*, JANYA MCCALMAN*, YVONNE CADET-JAMES!, STEVEN MARGOLIS# AND VALMAE YPINAZAR#

*The Cairns Institute, James Cook University, Townsville, QLD, Australia; +The Cairns Institute and the School of Education, James Cook University, Townsville, QLD, Australia; !School of Indigenous Australian Studies, James Cook University, Townsville, QLD, Australia; #School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia

Abstract: Background: This paper identifies the latent opportunities and challenges inherent in the formative stages of a project that was resumed after partial completion by other on-the-ground research teams. Methods: Grounded theory methods were used to analyse project documentation from previous research teams and to generate new process-oriented data. Results: The intention of all research teams was moving towards Engaging in Community-Based Participatory Research; this was conceptually identified as the core category. The social process involved in achieving community engagement practice was named Coming to an Ethics of Practice. Four different facets comprised the core category: Developing meaningful relationships; being reflective; recognising difference; and making research relevant. Conclusions: To achieve mutually beneficial outcomes, researchers conducting community-based research with Aboriginal people must implement strengths-based approaches to realise ethically sound research; prioritise the relevance of the research to the daily lives, needs and aspirations of those with whom they work; and in doing so, remain cognisant of their own philosophical position and context in which the research is located.

Keywords: Aboriginal Australians, grounded theory, remote research, research practice ethics

the processual challenges or enablers of conducting this type research. Particularly lacking in the lit-erature are descriptions of how researchers manage the tensions that inevitably arise when conducting community-based participatory research related to sensitive issues in remote Aboriginal Australian communities.

Written from an insider perspective, the authors of this paper engage with the opportunities and challenges of conducting community-based research with Aboriginal Australian partners. The article arose in the context of a research project that aimed to develop a model of palliative care pathways to support Aboriginal Australians liv-ing remotely with end-stage renal disease. The project was resumed following the initiation and implementation of the project by three earlier research teams. Within this context, the question posed was: What are the latent opportunities and research challenges associated with achiev-ing meaningful and effective community-based participatory research with members of a remote Aboriginal community? As a response, in this paper, presented is a theoretical model of the processes involved in conducting participatory

Ethics of research practice in an Aboriginal Australian community

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community had a government-run primary health care centre, and the Royal Flying Doctor Service, a non-government organisation, also serviced the community. All healthcare services bulk billed con-sumers and medications were provided. A range of outreach services including child health, drug and alcohol, community liaison development, health promotion and mental health were also provided (Lavarack et al., 2009). To counter the challenges of accessing medical care in remote communities, and as part of the government’s Closing the Gap strategies, Aboriginal people were provided with air travel and limited financial support when referred to a regional city for health care unavailable in their communities.

METHODS

The study ethics were approved by both James Cook University and Cairns Base Hospital Ethics Committees. The new research team approached the uptake of the research aligned with the decolo-nising agenda of Community-Based Participatory Research and Flyvbjerg’s (2001) notion of a phronetic social science (Bainbridge, Whiteside, et al., 2013). It was informed by the NHMRC ethical principles – spirit and integrity, respect, reciprocity, equality, survival and protection and responsibility. Flyvbjerg (2001) argues that epis-temic science contributes to the failure of social sci-entists to support societal betterment. Accounting for this proposition is particularly pertinent when considering research conducted with Aboriginal Australians (Bainbridge, McCalman, Tsey, & Brown, 2011; Bainbridge, Tsey, Andrews, & McCalman, 2013; Bainbridge, Whiteside, et al., 2013); whether located in or outside of that culture. Contemplating differing epistemic cultures at play in situations means questioning how systems and processes work and what principles inform their positioning and orientations (Bainbridge, Tsey, et al., 2013). This means for example, acknowledg-ing Aboriginal agency in the context of changing complex socio-political environments and compet-ing interests; continuity of culture; the impact of colonial legacies; and the legitimacy of their advo-cacy for change, including systemic change. Thus the idea of a phronetic social science approach is accomplished by the analysis of values and power ‘as a point of departure for action’ (Flyvbjerg,

research in a palliative care setting with Aboriginal partners. Based on these process findings, practice issues and implications for future research devel-opments and relationships are considered.

Research contextEarlier research teams were comprised mixed gender chief investigators and research officers; all were non-Aboriginal. The new team was led by two chief investigators (an Aboriginal woman and non-Aboriginal man); two on-the-ground research officers (Aboriginal women); a home support researcher (non-Aboriginal woman) and a cultural advisor (Aboriginal man). The engage-ment of the cultural advisor with family links in the local community was deemed critical by the new research team to the safety of both commu-nity participants and researchers.

The research was undertaken with members of a discrete remote Aboriginal Australian community. At the time of study, there were no dedicated pal-liative care services for Aboriginal people residing in remote areas; specialist knowledge and resources and staffing were almost non-existent. In terms of choice, palliative residents in these regions are undoubtedly among the most vulnerable populations in Australia. Palliative care in their homelands was dependent on clinical and health staff, community organisations and families and individuals doing the best they can to manage health and wellbeing (Bainbridge et al., 2013) under extremely challenging conditions. Care occurred at the confluence of Western and Aboriginal belief systems, and within the constraints of restrictive policies and systems, and challenging geographical spaces. The closest urban and special-ist medical centre was located some 90 minutes flying time or 9 hours drive away (Lavarack, Hill, Akenson, & Corrie, 2009). Health services in par-ticular operated in environments where there were few, if any, alternate services, limited participation by non-government organisations, and few general practitioners (Rogan, 2005). Compounding the delivery of services were issues of distance, travel and access which were hampered by weather conditions. The wet season severely impacted possibilities for travel and access for 6 months of the year. During this time, service provision was restrained, including fundamentals such as fresh food and produce. The

Roxanne Bainbridge et al.

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identified as the core category. The social process involved in achieving community engagement practice was named Coming to an Ethics of Practice. Four different facets comprised the core category: Developing meaningful relationships; being reflec-tive; recognising difference; and making research relevant. The individual facets were neither hierar-chical nor sequential. Rather, the model described as Coming to an Ethics of Practice is situated and connotes fluidity and adaption, with the different facets interrelated and interdependent.

Figure 1 seeks to capture fluid and adaptive movement. The process, Coming to an Ethics of Practice is portrayed by the developmental phases of the environmental atmospheric phenom-enon known as a whirly-whirly. The action evokes imaginings of the ‘research dance’ (Mayo & Tsey et al., 2009) between communities and research-ers. The metaphorical whirly-whirly encapsu-lates the ways in which researchers interact with community by developing meaningful relation-ships, being reflective in an action research pro-cess and recognising and accommodating different ways of being, and making research relevant to the needs of the community. Significant also, was the way researchers go about their business of engag-ing in community-based participatory research by

2001, p. 57). The approach seeks a workable ethical course of action that focuses on localised Aboriginal knowledge and responds to the variable or particular, as opposed to the universal and con-text-independent (Bainbridge, Tsey, Andrews, et al., 2013; Flyvbjerg, 2001; Tsey, 2010). This raises ethical questions to which the aforementioned NHMRC principles respond, and, are invaluable as an approach to research practice.

Data generationData for the analysis were generated from three sources. First, data that was generated from the project documentation of the three earlier research teams were used. These included: The grant pro-posal, meeting minutes, reports and researchers’ reflections. Second, detailed notes and recordings of reflective sessions between the new team and previous teams around their perceptions of the project’s challenges and opportunities were incor-porated. Third, newly-generated data in the form of observations and reflections generated by the new team were integrated into the analysis along with memos which documented community engagement, feedback sessions to the community and completion of the project by the new team in an ‘all is data’ approach (Glaser, 1998, p. 8).

Data analysisOne researcher (RB) concurrently analysed the existing project documentation to ascertain the opportunities and challenges inherent in the project. Data was analysed using constructivist grounded theory methods. Memos and con-cept maps were used as a visual tool to explore the interconnectedness of identified concepts. Further data generation occurred through ‘theory-directed sampling’ (Birks & Mills, 2011, p. 69). A core category was identified and other catego-ries integrated to build a theoretical explanation; a narrative that illuminated all of the categories, their dimensions and the ways in which they were related (Birks & Mills, 2011; Charmaz, 2006).

RESULTS

The compelling intention of all research teams was moving towards Engaging in Community-Based Participatory Research; this was conceptually FIGURE 1: COMING TO AN ETHICS OF PRACTICE


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adopting a philosophical position that enables them to come to an ethics of practice. This encapsulates a notion of mutual interchange between the research-ers and communities to maintain the energies to generate new relationships and perspectives together.

Developing meaningful relationshipsDeveloping meaningful relationships in the research undertaking was recognised by all teams as fundamental to its success: Discussions were pervasive and consistently interwoven throughout the research narratives of the original teams and a priority for the new team. All teams acknowl-edged that there were the challenges in doing so. Original teams encountered specific difficulties in developing relationships with community mem-bers, and to a lesser extent community researchers and leaders. Research correspondence noted that ‘It was problematic to get Indigenous researchers on-board and involved in the interview process…This has affected access to potential participants’. As a result, the need for a more participatory approach was flagged (Meeting Minutes). These challenges were compounded by a substantial time lapse between initial community engagement and funding, a lack of continuity of research leadership on-the-ground, a shortfall in the budget, changing community leadership, changing socio-political circumstances in the community and the passing of some participants. These issues in turn ‘left the project with few community members with end-stage renal disease (ESRD)’ (Meeting Minutes) and waning community interest and engagement.

The new on-the-ground team faced similar, but different challenges in community engagement. The Aboriginality of the on-the-ground team and the brokering of relationships by a cultural advisor put them in a privileged position and establishing meaningful relationships with the community was not problematic. Expediency of acceptance into the community was initially by virtue of their eth-nicity and then later through introductions to the community by the cultural advisor. This is not to say impediments to engagement were non-existent. Upon the first community visit, and without the presence of the cultural advisor, the new team was initially confronted with a ‘Come on, let’s get this over and done with’ from one community leader.

Their relationship turned around upon identifying their cultural and family relationships: Offers of research assistants and cars were then forthcoming. The research team worked hard to develop these relationships; they respectfully prioritised develop-ing trusting and meaningful relationships by shar-ing critical information; meeting with community representatives; sharing meals; holding afternoon teas and barbeques and offering reciprocal support such as writing letters, moral support and so forth.

It was the expectations that flowed from these relationships that were difficult. For example, complications arose in maintaining an optimal relationship with the cultural advisor. Three fac-tors impacted on the relationship. First, there were differing perceptions on the nature of research, the role of researchers and what researchers had the capacity to do. For instance, the cultural advi-sor had expectations that the team could provide resources to patients, such as motorised wheel-chairs. Second, it was difficult to maintain integ-rity in the relationship and work within university systems. All efforts, for example, to renumerate the cultural advisor in a reasonable timeframe were never adequately resolved and left its mark on the relationship. Third, the two women were caught in a quandary over the expectations of them as Aboriginal women researchers. On one particular occasion, for example, a participant also had expectations that researchers were able to purchase equipment, provide input into other care efforts, and act as advocates in legal capaci-ties. This dilemma weighed heavily on their con-science as Aboriginal women and they found it extremely difficult to balance roles. When dis-cussions failed to resolve issues, part of solution was to provide an outside debriefing mechanism for the cultural advisor in addition to in-team debriefing for the researchers.

Research timeframes and distance were seen as key challenges to developing meaningful rela-tionships with participants. Travelling to remote communities was difficult, particularly given expenses, seasonal conditions and lacking accom-modation. This intermittent access made it more challenging for the researchers to develop the rela-tionships necessary for probing sensitive issues. As a research leader reflected:


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I think that it is important to take some time with interviews. My preference is to extend the conversation with participants beyond a single interview. I believe that some level of trust can be developed that will open up the interview space and allow harder questions to be asked and prevent particular information slipping through the cracks.

Maintaining contact, even when not in the com-munity, became important for the research team. Communication strategies included employing the local cultural advisor; email and phone contact; developing researcher profiles (placed strategically around the community) and working with the whole community. For example, a community bar-beque, which was piggybacked onto existing social structures, was held to facilitate building new rela-tionships. Given that the two researchers were not from that community, these approaches were deemed particularly critical. As reciprocal gesture for the hospitality shown by community members, a barbeque was purchased for their utility.

Being reflectiveBeing reflective was key to conducting ethical research and required more than thought in isola-tion. It required careful contemplation in conjunc-tion with involved others and learning from the past, which was then followed-up with appropriate actions. One early researcher, for example, sought to act on his reflections and be more flexible and inno-vative in his engagement. He suggested ‘that the health worker, guided by the Interest Groups’ rec-ommendations, could play a documenting role … [The researcher] would assist the health worker in the documentation’. While this proposition derived from being reflective, this effort towards collabora-tion never eventuated, and was unsurprising given the absence of those who would be involved, focus on the end goal in lieu of process and learning, and hectic schedules of health workers and others in the clinic. Despite the challenges nevertheless, research-ers remained positive and reflected this by iden-tifying progress, naming new opportunities and seeking more involvement with the community.

Research teams were astute in recognising opportunities and challenges in the research project through reflective practice. However for some, there were difficulties in interpreting

why these presented, and, in self-reflecting to understand how they could make their practice better. While teams identified opportunities, such as issues of self-care mechanisms for researchers, these were never adequately actioned or managed and remained unresolved. Contrariwise, the new team had the benefit of learning from the previ-ous team, the support of each other and a cul-tural advisor and many years working together as a team using participatory approaches with Aboriginal people. The new team reflected on one account that: ‘This [lacking data collection] also relates to the long lead-time required to build rap-port to create an environment conducive to allow-ing this communication to occur’.

The new team carefully used reflective prac-tice as a tool to manage any adverse incidents and opportunities to drive further decisions and actions. Reflection was done both as individuals and as a group. As an example, having observed the community lean towards palliative care needs more generally, vis-à-vis only for end-stage renal patients, the team followed-up with community consultation (including and being led by the community advisor, service providers, the Health Action Team and pastoral/spiritual care support) to verify this shift in priorities. They then mobil-ised to include other palliative care patients as rec-ommended by these groups.

Recognising differenceFor all researchers, coming into the community as an outsider represented challenges. Despite considering themselves outsiders to the commu-nity, the new team also realised their ‘insiderness’ and inherent relationality; this was evidenced in the warm welcome received by Traditional Custodians, children approaching them in the street and addressing them by name, adult community members unknown to them stopping them in the street for casual conversation, dinner invitations and requests from participants to call or drop by. Coming to such a position was quite overwhelming for the new team and indeed for community mem-bers. A most powerful experience was described of community blessings for the project: The team was humbled in the presence of Traditional Custodians as they emotionally expressed their permission


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for the research project to proceed. The emotive response emanated from the respect accorded to the Traditional Custodians by the new team; some-thing they rarely experienced.

Recognising difference was embedded as a crucial part of the project, and all research teams had considerable experience with cross-cultural research and commitment to supporting research that benefi tted Aboriginal people. However, there were dissenting epistemologies between Aboriginal and other Australians, which were clearly at vari-ance with each other and at play within project activities. For example, the original teams refl ected that there was a need to ask the hard questions of participants (about death and dying) which Aboriginal researchers considered to be both intrusive and unnecessary. Nonetheless, the origi-nal research proposal always had the intention of strengthening local capacity and employ commu-nity researchers: ‘Intensive training was arranged to familiarise two staff with appropriate qualitative research methods’. They also understood that with English as a second language for many community members, standard English and Eurocentric-based survey instruments would not suffi ce. The original teams sought input from community researchers to address this issue. Interestingly, this application did not translate to Information Sheets and Consent Forms in the project. These documents were sub-sequently adapted by the new team with more accessible language (although still in English, but reviewed by the community advisor) and with visu-als included. Developing meaningful relationships with the community, understanding difference and having cultural insight, and being refl ective did not nevertheless, mean that researchers were always able to accommodate community perceptions and needs. For example, when the new team fed back the project results to the community, the dissemi-nation products and text (a fl yer and a poster) still required reworking to make them more relevant to community needs.

Gender differences also came into contention within the context of the research. With cultural insights, the new on-the-ground research team that comprised two Aboriginal women, was critically alert to the need for gender balance and sought a cultural advisor who could accommodate this

need. Gender difference was also noted by the earlier teams as a barrier to data collection. This is evidenced by one researcher who refl ected that, ‘The gender of potential interviewees was also a diffi culty, with young women family members who were acting as primary carers agreeing to be inter-viewed at a later time without this ever occurring’.

Making research relevantTo a large degree, making research relevant was at the heart the process of Engaging in Community-Based Participatory Research. But in many ways, it was one of the most confronting challenges given the early lack of community interest, engagement and support. As a member of the original team noted: ‘I had suggested that the project should not been continued, as the people of [name of community] had more or less “voted with their feet” to not participate’ (Meeting Minutes).

Opportunities were presented for the new team to discuss issues of research relevance with community leaders. The leaders suggested that community was not engaged with the concept of research in its broader understanding, or their rights to partake, or not, in research. The new team strategised a strengths-based approach: They advocated for a collaborative approach to the research; expressed the relevance and benefi ts of the research to the community; inquired as to the relevance of the research topic and ways to move forward; and shared stories of their own exaspera-tions with lack of social change and community control and how this agenda could be moved for-ward. Underpinning this approach was an ethics of care and responsibility towards the community and an invitation was extended to return and move forward with the project in a more partici-patory way. This sentiment had previously been commented upon by one of the original research-ers: ‘the community-based health worker would fi nd more relevance and interest in a more partici-patory, experiential approach’ (Meeting Minutes).

With two on-the-ground Aboriginal research-ers, a cultural advisor and the benefi t of hind-sight, the challenges of developing meaningful relationships, being refl ective, recognising dif-ference and making research relevant were facili-tated. Nevertheless, providing research feedback


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that was relevant and useful to the community at different levels was difficult to manage given the travel distance and limited funding. By being creative and taking up other opportunities, the research team was able to deliver this feedback, and as a result, was able to work on community-friendly resources to raise the profile of renal dis-ease and palliative care choices and pathways.

DISCUSSION

Through a process identified as Coming to an Ethics of Practice, the reflections and stories of four successive research teams were analysed to relate the latent opportunities and challenges of operationalising their intentions of Engaging in Community-Based Participatory Research in Aboriginal research contexts. Specific opportuni-ties and challenges were detailed in the findings (See Table 1). Opportunities were demonstrated by the research capacity and expertise of the research

teams. Challenges stemmed from managing the constraints of working on-the-ground in remote Aboriginal communities and engaging with com-munity in a participatory approach. The new team benefitted from hindsight, experience of working in partnership with Aboriginal people, working from a strengths-based approach and having an Aboriginal team on-the-ground driving the way forward in the project.

Importantly, the findings add further dimen-sions to understanding engagement in commu-nity-based participatory research, a deeper ethical dimension to research practice; this includes the significant value of Aboriginal researchers and cul-tural advisors to research projects; and the transla-tion of theory to practice. The findings also confirm the well-documented literature relating the oppor-tunities, challenges and best practice guidelines for conducting research with Aboriginal partners (Bainbridge, Whiteside, et al., 2013; Brands &

TABLE 1: ATTRIBUTES OF COMING TO AN ETHICS OF PRACTICE IN ENGAGING IN COMMUNITY-BASED PARTICIPATORY RESEARCH – OPPORTUNITIES AND CHALLENGES

Opportunities for engaging in community-based participatory research

Challenges to engaging in community-based participatory research

Developing rigorous research management processes Changing research leadership and researchersBuilding local research capacity Constraints of funding bodiesDeveloping authentic community engagement at all levels

Reliance on outside structures

Authentic community engagement at all levels

Obtaining gender balance in the research team

Maintaining community interest and support

Obtaining primary interview data

Developing rapport with the community and community researchers

Engaging community with the concept of research

Constraints of time

Changing social and political community environment

Cultural barriers including language

Non-participatory, experiential approaches to research

Making research relevant to community needs

Flexibility and responsiveness in research

Balancing the roles of Aboriginal women as researchers

Developing meaningful relationships (trusting and respectful relationships) at all levelsKnowing key informantsEngaging in context-dependent researchEngaging in community-driven researchEngaging a participatory approachUsing a strengths-based approachMaking research relevant to community needsBringing humanity to the research – empathy and debriefing mechanismsRecognising differenceInvolving Aboriginal researchers on-the-groundEmploying a local cultural advisor/mentorSupporting Aboriginal self-determinationHaving cultural sensitivityHaving a gender balanceMaking timeBeing patient; responsive; flexible; reflexive; innovative; respectful


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Gooda, 2006; Martin, 2003, 2008; Mayo & Tsey et al., 2009; McKay, Kõlves, Klieve, & De Leo, 2009; National Health and Medical Research Council, 2003, 2006; Tsey, 2010; Tuhiwai Smith, 1999). Particularly noted is the importance of community-driven research (Bainbridge, Tsey, et al., 2013). It was important to firstly understand community strengths – what people are already doing – and how researchers can add value to existing structures. Such practices are championed by Aboriginal advocates and researchers, funding bodies, research institutions and others involved in working relationships with Aboriginal partners.

Emphasised in this analysis is the critical impor-tance of reflexivity and genuine community engage-ment as a point of departure for action in developing research partnerships with Aboriginal people. It is evident that there are still deep-seated issues of trust and respect between Aboriginal participants and non-Aboriginal researchers. Aboriginal Australian scholar Martin and Mirraboopa (2003) articulates the value of reflexivity for Aboriginal researchers. She states that reflexivity in research design affords the space to ‘decolonise western research method-ologies, then harmonise and articulate Indigenist research. Reflexivity is a process that allows us to work from Aboriginal centres and ensure we work with relatedness of self and Entities. Reflexivity challenges us to claim our shortcomings, misun-derstandings, oversights and mistakes, to re-claim our lives and make strong changes to our current realities. Being reflexive ensures we do not com-promise our identity whilst undertaking research’ (Martin & Mirraboopa, 2003, p. 212).

For non-Aboriginal researchers, to some degree, the complexities of conducting research with Aboriginal partners can be stabilised and brought to a more ethical position by the increased prac-tice of reflexivity, which has as its primary goal the reduction of ‘unintentional effects of power’ (Hesse-Biber & Leavy, 2008, p. 4). It does this by attending to how ‘biography, authorship and textual representations mediate the knowledge-building process’ (Hesse-Biber & Leavy, 2008, p. 4). Reflexive practice aims to ensure that the underlying politics of our research methods and assumptions are analysed self-consciously, rather than remaining unacknowledged (Hertz, 1997).

First and foremost, enshrined in documents and literature about engagement in community-based participatory research is the creation of col-laboration and partnerships within an ethical space (Bainbridge, Whiteside, et al., 2013; Minkler, 2004). Critically, this requires a commitment to empowering, inclusive, participatory processes that engages both Aboriginal and research commu-nities, and that includes community consultation, ownership and inclusivity. The NHMRC (2003) resource document, Values and Ethics – Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research provides a framework for this discussion. What is perhaps not clear in the NHMRC Guidelines and what is most difficult, is understanding how to translate ethics theory into practice on-the-ground. Researchers reflected that ‘their (community members’) interest has signifi-cantly declined over time as other issues developed and occupied an increasingly large proportion of their time, energy and resources’. Developing meaningful and productive relationships with the community was at the crux of this issue. From the outset, some difficulties might have been averted by using action research as a tool to define com-munity issues and include them more in project planning and design. The action research process could have facilitated a deeper understanding of the research issue, particularly through tapping into the intricate local knowledge of Aboriginal researchers and cultural advisors who, by virtue of their ethnicity, have access to spaces, and can open doors to engage participants. This aligns with the NHMRC ethical principles, supports community analysis, decision-making and sustainability of the research. It also aligns with the experience and evidence described by Brands and Gooda (2006) as a Facilitated Research Development Approach. This research approach involves developing and setting research agendas with Aboriginal partners leading to community-driven research vis-à-vis investigator-driven research; collaboration not competition; and benefits to both community and researchers (Brands & Gooda, 2006).

CONCLUSION

While ethical guidelines for Indigenous health research have been espoused by research


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institutions over recent years, implement-ing these is problematic for many researchers. Inviting Aboriginal participants to engage with the concept of research, the specific project under investigation and developing authentic research relationships is complicated, and dif-ficult to sustain in the longer-term no matter what the constitution of the research team. The task is further compounded by restrictions of locations, time, funding constraints and expec-tations and coming to understand difference. To achieve mutually beneficial outcomes, research-ers conducting community-based research with Aboriginal people must implement strengths-based approaches to realise ethically sound research; prioritise the relevance of the research to the daily lives, needs and aspirations of those with whom they work; and in doing so, remain cognisant of their own philosophical position and context in which the research is located. In terms of the latter, this means researchers must critically reflect on the research process consid-ering: Diversity as a priority in the research con-text; coming to a value-centred, action-oriented approach to research that promotes commu-nity engagement in a culturally safe, cultur-ally respectful way (Irabinna Rigney, 1999). The researcher should take positionality, their individual vantage points of influence upon the research into account; such as the ways in which identities, ethnicity, profession, age, gen-der, class and so forth, potentially influence and shape research relationships, processes and out-comes (Bainbridge, McCalman, & Whiteside, 2013; Birks & Mills, 2011). They should also use the renewal of their reflections as a point of departure for action.

Ethical research practice encourages having Aboriginal participants as initiating research, partnering as stakeholders and involved in the practical research endeavours. It must be tai-lored to support self-determination and respond to community needs and concerns as advocated by them. This occurs through acknowledgement and investiture of Aboriginality within local ecol-ogies and languages and in defining Aboriginal knowledge. Communities must have full knowl-edge and understanding of what the research

programme is, its sustainability and benefits and opportunities to strengthen local capacity through the process. They must be consulted and kept informed through effective communi-cation strategies and work towards developing community owned and controlled programmes. Importantly, action towards these goals must be located in an ethical, spiritual context as well as its physical, historical and social situation. It must recognise difference by understanding that knowledge differs when viewed from differ-ent perspectives; and practice must include new premises that value diversity and add value to existing strengths and contribute to their goals and aspirations.

ACKNOWLEDGEMENTS

The authors would like to acknowledge and extend appreciation to Brian Connolly for his guidance and support and Michelle Redman-MacLaren for her comments on an earlier draft. We acknowledge financial support to conduct the research from the National Health and Medical Research Council.

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Received 13 June 2013 Accepted 30 September 2013

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