title: The health-related quality of life of Indigenous populations: a global systematic review.
abstract: Indigenous conceptions of health have been shown to differ from that of their non-Indigenous counterparts. As a result, there remains uncertainty over the appropriateness and value of using existing health-related quality-of-life (HRQoL) instruments in Indigenous communities. The objective of this review was to identify studies that either measure the HRQoL of an Indigenous population or validated a measure used to elicit the HRQoL in an Indigenous population.
  
  
  
  A systematic review of the published literature was conducted to (1) investigate the extent to which HRQoL instruments are used in Indigenous populations; (2) to identify which instruments have been validated in which populations; and (3) to identify which instruments have been tailored for use with Indigenous populations.
  
  
  
  Forty-one studies were included in the review. Only three of the 41 studies utilised Indigenous-specific instruments. The remainder (38 studies) utilised generic population or disease-specific instruments. Four studies found specific HRQoL instruments to be valid in these populations and 32 estimated the HRQoL of an Indigenous population. The limited examples of Indigenous-specific instruments highlighted the potential importance to the HRQoL of these populations of domains that lie outside of traditional measures including social and community domains as well as domains relating to culture, diet and land use on top of more traditional HRQoL domains.
  
  
  
  Ensuring that the HRQoL of Indigenous populations is being appropriately measured is vital to prioritising available resources to the most effective interventions. HRQoL instruments present an opportunity to directly elicit and incorporate Indigenous preferences and conceptions of health into these decisions. Further work is required in the field to ensure that this potential is realised.
authors.affiliation: The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia. bangell@georgeinstitute.org.au.|The Poche Centre for Indigenous Health, Sydney Medical School, The University of Sydney, Sydney, Australia. bangell@georgeinstitute.org.au.
authors.forename: Blake
authors.initials: B
authors.lastname: Angell
authors.affiliation: The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia.|The Australian Prevention Partnership Centre, Sydney, Australia.
authors.forename: Janani
authors.initials: J
authors.lastname: Muhunthan
authors.affiliation: The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Eades
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
authors.forename: Joan
authors.initials: J
authors.lastname: Cunningham
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
authors.forename: Gail
authors.initials: G
authors.lastname: Garvey
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
authors.forename: Alan
authors.initials: A
authors.lastname: Cass
authors.affiliation: School of Public Health, University of Sydney, Sydney, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Howard
authors.affiliation: Flinders Health Economics Group, School of Medicine, Flinders University, Adelaide, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Ratcliffe
authors.affiliation: School of Public Health, University of Sydney, Sydney, Australia.|Aboriginal Health and Disadvantaged Communities, Baker IDI Heart and Diabetes Institute, Sydney, Australia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Eades
authors.affiliation: The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia.|The Poche Centre for Indigenous Health, Sydney Medical School, The University of Sydney, Sydney, Australia.|The Australian Prevention Partnership Centre, Sydney, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Jan
mesh_terms: D003469:Culture; D003625:Data Collection / Q000379:methods; D006304:Health Status; D006801:Humans; D016239:MEDLINE; D044382:Population Groups; D011788:Quality of Life; D015203:Reproducibility of Results
keywords: Health-related quality of life; Indigenous populations; Quality-of-life instruments; Systematic review