The University of Newcastle, Australia

Indigenous health in Indigenous hands

Dr Michelle Bovill is investigating culturally responsive approaches to empower Aboriginal women to quit smoking during pregnancy.

Image of Michelle Bovill

Dr Michelle Bovill has a refreshing, person-centred approach to Indigenous health.

A Wiradjuri woman and NHMRC early-career researcher, Michelle is partnering with Aboriginal communities to place the power in their hands and address an important area to improve Indigenous health: smoking during pregnancy.

“I want to improve the health of our mothers and babies—our future elders—by providing them with more appropriate health supports and services.”

Michelle’s incredibly successful research career is underpinned by her practical understanding of culturally responsive support services, which she gleaned through lived experience and many years in youth work, community development and out-of-home care.

“If we built health supports and services with the guidance of Aboriginal values—including respect, reciprocity and trust—all Australians would receive better support, especially those from vulnerable groups.

“I am excited to bring my communities’ voices to the research space. I want to conduct research in partnership and co-ownership with my people so that it can be meaningful and beneficial to us and our future generations.”

Collaborating for change

Michelle’s research is fuelled by a genuine desire to collaborate with Indigenous communities, listen to people’s experiences and share their stories.

When combined with her astute research mind, it’s no wonder that Michelle received her NHMRC fellowship even before submitting her PhD thesis—a rare and impressive feat. Michelle’s wildly successful PhD study explored healthcare delivery and smoking cessation support for Aboriginal women during pregnancy.

“It was a privilege to work with Aboriginal women to share their voices and experiences in the development of smoking cessation supports that are empowering for them.”

Not many researchers could claim a 100 per cent agreement rate for their first healthcare study.

It’s an especially extraordinary claim when the people involved belong to a group who can experience unique barriers to accessing quality healthcare. Yet Michelle’s research achieved just that—a true testament to her inclusive, community-focused research style.

“I wrote the research, but I don’t see it as mine. It belongs to the women sharing their stories. I feel honoured to be able to raise their voices in this space.”

Reproducing success

Michelle’s PhD work informed the highly successful Indigenous Counselling and Nicotine (ICAN) Quit in Pregnancy program, led by the University’s Associate Professor Gillian Gould and Professor Billie Bonevski.

The program supports smoking cessation during pregnancy across six Aboriginal communities in three states. In essence, it examines whether culturally appropriate training helps providers use evidence-based behaviour change techniques to support pregnant women to quit smoking, compared to using their standard model of care.

“I wanted to know if, through empowerment, Aboriginal women can achieve cessation. So we are measuring the growth and empowerment of Aboriginal women through their pregnancy to see if there is any change when they are offered culturally responsive smoking cessation support.

“To date, research in this setting is deficit-focused, reporting the high rates of smoking during pregnancy; however, women are often just doing what their doctors are telling them to do—which is to reduce their smoking. But doctors should be advising quitting if we are only measuring quit rates.”

In 2019, Michelle’s work was recognised for its contribution to community health when she received the nationally prestigious Lowitja Institute Aboriginal and Torres Strait Islander Student Award.

Community-driven solutions

During her PhD, Michelle was continually asked by Aboriginal and Torres Strait Islander women to explore more “natural” options to support smoking cessation. The suggestion guided her research into the area of nonpharmacological support options, and led to her most recent NSW-based study, Which Way? Smoking Cessation.

The study will partner with four to five Aboriginal NSW communities to explore what cessation strategies are of interest to Aboriginal women and their health providers. These strategies may include psychotherapy-based strategies such as counselling, use of technologies like phone apps or phone-based counselling, mindfulness, yoga, acupuncture, group therapies or exercise.

Michelle is confident that smoking cessation success rates could be increased with the right supports that are meaningful to Aboriginal and Torres Strait Islander women. But to ascertain what works, we must start by talking with women about the types of support they are likely to engage with during pregnancy and beyond.

Which Way? Smoking Cessation is entirely community-led and begins by asking Aboriginal women “which way?”, which is a commonly used phrase in Aboriginal communities and has a broad meaning, used in connection to “what, where and how”. The study privileges Aboriginal women’s voices and experiences to understand which supports are desired and gather appropriate evidence for future services.

“My research is driven by community voices and experiences. It’s also conducted in long-term partnership and co-ownership with Aboriginal communities.

“We (Aboriginal people) have long stated that we have the solutions for our people. I am committed to long-term partnerships to co-develop the right supports to address smoking during pregnancy. I don’t approach communities with an ‘intervention’. I ask communities what they need, then measure and monitor those services.”

Alongside her core research, Michelle continues to be involved in national and international collaborations into Indigenous health research ethics and smoking during pregnancy across population groups.

Michelle is also proud to support emerging Indigenous researchers and students within the University’s Yapug program teaching Community and Research.

“It’s exciting to be supporting the next wave of Aboriginal and Torres Strait Islander students and health researchers.

“We need to engage Aboriginal and Torres Strait Islander communities as equal partners. Only then can we deliver health research that is appropriate and meaningful for our communities.”