Islam Md Irteja, Lam Bernadette Yan Yue, Esgin Tuguy, Martiniuk Alexandra
Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Edward Ford Building, A27 Fisher Road, Sydney, NSW 2006, Australia.
Research, Innovation and Grants, Spreeha Bangladesh, Gulshan-2, Dhaka 1212, Bangladesh.
Behav Sci (Basel). 2024 Nov 5;14(11):1047. doi: 10.3390/bs14111047.
Improving social and emotional well-being (SEWB) among Indigenous adolescents is crucial. Since neurodevelopmental disorders (NDDs) are common in Indigenous people and adverse childhood experiences (ACEs) are important contributors to negative health outcomes throughout the lifespan, we investigated whether limited ACE exposure is associated with reduced risk of NDDs in Australian Indigenous teens using the data from multiple waves (Wave 1 to Wave 9, and Wave 11) of the Longitudinal Study of Indigenous Children (LSIC). We also examined the role of other protective factors, such as Indigenous cultural identity and school connectedness, against NDDs. A strengths-based approach using mixed-effects logistic regression models examined the protective effect of limited ACE exposure (from LSIC waves 1-9) on NDDs (outcome from LSIC wave 11), adjusting for sociodemographic factors. The NDDs included autism, ADHD, intellectual, neurological, and specific learning disabilities. Of the 370 individuals analysed, 73.2% valued Indigenous cultural identity, and 70.5% were strongly connected at school. More than one-fourth (27.8%) reported limited ACE exposure, while the majority was not diagnosed with NDDs (93%). Longitudinal analysis revealed limited ACE exposure was 6.01 times (95% CI: 1.26-28.61; = 0.024) more likely to be protective against NDDs compared to those exposed to multiple ACEs. Moreover, valuing cultural identity (aOR = 2.81; 95% CI: 1.06-7.39; = 0.038) and girls (aOR = 13.88; 95% CI: 3.06-62.84; = 0.001) were protective against NDDs compared to their respective counterparts. Our findings highlight the need to prevent ACE exposure and promote Indigenous cultural identity in preventing negative health outcomes and the exacerbation of health inequities to strengthen the SEWB of Indigenous communities.
改善澳大利亚原住民青少年的社会和情感幸福感（SEWB）至关重要。由于神经发育障碍（NDDs）在原住民中很常见，且童年不良经历（ACEs）是导致一生负面健康结果的重要因素，我们利用原住民儿童纵向研究（LSIC）多轮（第1波至第9波以及第11波）的数据，调查了澳大利亚原住民青少年中有限的ACE暴露是否与NDDs风险降低相关。我们还研究了其他保护因素，如原住民文化身份和学校归属感，对NDDs的作用。使用混合效应逻辑回归模型的基于优势的方法，检验了有限的ACE暴露（来自LSIC第1 - 9波）对NDDs（来自LSIC第11波的结果）的保护作用，并对社会人口学因素进行了调整。NDDs包括自闭症、注意力缺陷多动障碍、智力、神经和特定学习障碍。在分析的370名个体中，73.2%重视原住民文化身份，70.5%在学校有很强的归属感。超过四分之一（27.8%）的人报告ACE暴露有限，而大多数人未被诊断患有NDDs（93%）。纵向分析显示，与暴露于多种ACEs的人相比，有限的ACE暴露对NDDs具有保护作用的可能性高6.01倍（95%可信区间：1.26 - 28.61；P = 0.024）。此外，与各自的对照组相比，重视文化身份（调整后比值比 = 2.81；95%可信区间：1.06 - 7.39；P = 0.038）和女孩（调整后比值比 = 13.88；95%可信区间：3.06 - 62.84；P = 0.001）对NDDs具有保护作用。我们的研究结果强调，有必要预防ACE暴露并促进原住民文化身份，以防止负面健康结果以及健康不平等加剧，从而加强原住民社区的社会和情感幸福感。
