Background:
The time between childhood and adulthood is when an individual acquires the physical, cognitive, social, and economic resources that are foundational to health and wellbeing later in life. The psychological and physiological transitions of youth are compounded by profound transitions in social role, including those related to employment, education, and family role. Additionally, Indigenous youth are developing their cultural identity while also contending with challenges of ongoing colonisation and everyday lived experiences of racism which negatively impacts their health and wellbeing. A comprehensive assessment of Indigenous youths’ health and wellbeing could enable early diagnosis and respond to physical and mental ill health concerns. This narrative systematic review synthesizes evidence about the acceptability and utility of primary health care-based health assessments for improving the health and wellbeing of Indigenous youth.
Methods:
A systematic search strategy was applied to 20 electronic databases (four bibliographic and 16 grey literature). Studies were included if they reported on health assessments conducted in primary health care with youth aged 12–24 years who were Indigenous to Australia, New Zealand, Canada, United States of America (USA), Taiwan, and the arctic regions of Scandinavia and Russia. Two independent reviewers performed the study selection, quality appraisal and data extraction. A narrative synthesis was undertaken.
Results:
Of the 3061 unique studies identified, seven met the eligibility criteria and were included: four mixed-methods studies, two qualitative studies and one quantitative study. Included studies showed youth health assessments were useful for making new diagnoses, detecting social and emotional wellbeing concerns, and some biomedical parameters. Co-created health assessments with Indigenous youth conducted by clinicians familiar to community were well accepted. Digital health assessments administered using an electronic tablet provide advantages. No health outcomes were reported. Additionally, no health assessments addressed the impacts of colonisation and racism.
Conclusion:
There is insufficient evidence to make firm conclusions about benefits of health assessments; however, health assessments can be useful for detecting new diagnoses and concerns regarding social determinants of health and social and emotional wellbeing. Future development of Indigenous youth health assessments needs to involve Indigenous youth’s perspectives, ideas and, interpretations of health.