Assessing the quality of health research from an Indigenous perspective: the Aboriginal and Torres Strait Islander quality appraisal tool
Open accessAbstract
Background: The lack of attention to Indigenous epistemologies and, more broadly, Indigenous values in primary research, is mirrored in the standardised critical appraisal tools used to guide evidence-based practice and systematic reviews and meta-syntheses. These critical appraisal tools offer no guidance on how validity or contextual relevance should be assessed for Indigenous populations and cultural contexts. Failure to tailor the research questions, design, analysis, dissemination and knowledge translation to capture understandings that are specific to Indigenous peoples results in research of limited acceptability and benefit and potentially harms Indigenous peoples. A specific Aboriginal and Torres Strait Islander Quality Appraisal Tool is needed to address this gap. Method: The Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT) was developed using a modified Nominal Group and Delphi Techniques and the tool’s validity, reliability, and feasibility were assessed over three stages of independent piloting. National and international research guidelines were used as points of reference. Piloting of the Aboriginal and Torres Strait Islander QAT with Aboriginal and Torres Strait Islander and non-Indigenous experts led to refinement of the tool. Results: The Aboriginal and Torres Strait Islander QAT consists of 14 questions that assess the quality of health research from an Aboriginal and Torres Strait Islander perspective. The questions encompass setting appropriate research questions; community engagement and consultation; research leadership and governance; community protocols; intellectual and cultural property rights; the collection and management of research material; Indigenous research paradigms; a strength-based approach to research; the translation of findings into policy and practice; benefits to participants and communities involved; and capacity strengthening and two-way learning. Outcomes from the assessment of the tool’s validity, reliability, and feasibility were overall positive. Conclusion: This is the first tool to appraise research quality from the perspective of Indigenous peoples. Through the uptake of the Aboriginal and Torres Strait Islander QAT we hope to improve the quality and transparency of research with Aboriginal and Torres Strait Islander peoples, with the potential for greater improvements in Aboriginal and Torres Strait Islander health and wellbeing.
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The Indigenous Quality Assessment Tool (IQAT) is a standardized instrument that examines research pertaining to Indigenous peoples.
“The Indigenous Quality Assessment Tool (IQAT) is a standardized instrument that examines research pertaining to Indigenous peoples (Harfield et al., 2020).”
From Indigenous Autism in Canada: A Scoping Review (2024) · cites this paper as Harfield et al., 2020
The Method and Discussion describe a piloted, 14-question quality appraisal tool, supporting its description as an instrument for assessing research. But the paper calls it the Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT) and specifies that perspective and population; it does not identify a tool named IQAT or establish its use for research concerning Indigenous peoples generally. Page numbers are not available in the supplied passages. (LLM, conf=0.86)
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Riley, T., Anderson, N. E., Lovett, R. W., Meredith, A. L., & Cumming, B. (2022) · PLOS Global Public Health · doi:10.1371/journal.pgph.0000921 · Cited by 13 · see citing works
Luke, J., Verbunt, E., Bamblett, M., Salamone, C., Gafforini, S. A., Zhang, A., Thomas, D., Eades, S., Gubhaju, L., Kelaher, M., et al. (2023) · First Nations Health and Wellbeing - The Lowitja Journal · doi:10.1016/j.fnhli.2023.100007 · Cited by 13 · see citing works
Indigenous Autism in Canada: A Scoping Review
Bruno, G., Chan, T. A., Zwaigenbaum, L., Coombs, E., Circle, T. I. R., & Nicholas, D. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-023-06045-z · Cited by 12 · see citing works
“Some reviews assess quality and we have adopted this sixth stage; methodologic/research rigor was analyzed using the Indigenous Quality Assessment Tool (IQAT) (Harfield et al., 2020).”
BackgroundMethodPovey, J., Raphiphatthana, B., Torok, M. H., Nagel, T. M., Mills, P. P. J. R., Sells, J. R. H., Shand, F., Sweet, M., Lowell, A., & Dingwall, K. M. (2023) · Systematic Reviews · doi:10.1186/s13643-023-02262-w · Cited by 12 · see citing works
Turner, N., Taylor, J., Larkins, S., Clancy, K., Carlisle, K., Laurie, T., Vine, K., King, S., Redman-MacLaren, M. L., Felton‐Busch, C., et al. (2025) · First Nations Health and Wellbeing - The Lowitja Journal · doi:10.1016/j.fnhli.2025.100075 · Cited by 12 · see citing works
Redman-MacLaren, M. L., Turner, N., Taylor, J., Laycock, A. F., Vine, K., Thompson, Q., Larkins, S., Carlisle, K., Thompson, S., Bailie, R. S., et al. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.630611 · Cited by 12 · see citing works
Indigenous Peoples and Occupational Therapy in Canada: A scoping review
Bauer, H. F., Neal, E. C., Lizon, M. E., Jacek, C. C., & Fritz, K. M. (2022) · Canadian Journal of Occupational Therapy · doi:10.1177/00084174221088410 · Cited by 12 · see citing works
Lock, M., McMillan, F., Warne, D. K., Bennett, B., Kidd, J., Williams, N. G., Martire, J. L., Worley, P., Hutten‐Czapski, P., Saurman, E., et al. (2022) · Canadian Journal of Rural Medicine · doi:10.4103/cjrm.cjrm_25_22 · Cited by 12 · see citing works
Milroy, H., Kashyap, S., Collova, J. R., Platell, M., Gee, G., & Ohan, J. L. (2023) · PLoS ONE · doi:10.1371/journal.pone.0280213 · Cited by 12 · see citing works
Cochrane, F., Singleton-Bray, J., Canendo, W., Cornwell, P., & Siyambalapitiya, S. (2023) · International Journal of Speech-Language Pathology · doi:10.1080/17549507.2023.2181225 · Cited by 12 · see citing works
Anderson, K. M., Gall, A., Butler, T., Arley, B., Howard, K., Cass, A., & Garvey, G. (2021) · BMC Medical Research Methodology · doi:10.1186/s12874-021-01366-y · Cited by 11 · see citing works
Browne, J., Walker, T., Hill, K., Mitchell, F., Beswick, H., Thow, S., Ryan, J., Sherriff, S., Rossignoli, A., Ropitini, A., et al. (2024) · Food Policy · doi:10.1016/j.foodpol.2024.102676 · Cited by 11 · see citing works
Stephens, J. H., Grande, E. D., Roberts, T., Kerr, M., Northcott, C., Johnson, T., Sleep, J., & Ryder, C. (2025) · Current Hypertension Reports · doi:10.1007/s11906-025-01327-6 · Cited by 11 · see citing works
Effectiveness of programs aimed at obesity prevention among Indigenous children: A systematic review
Wahi, G., de Souza, R. J., Hartmann, K., Giglia, L., Jack, S. M., & Anand, S. S. (2021) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2021.101347 · Cited by 11 · see citing works
Porykali, B., Davies, A. J., Brooks, C., Melville, H., Allman-Farinelli, M. A., & Coombes, J. (2021) · Nutrients · doi:10.3390/nu13114084 · Cited by 11 · see citing works
ICIRAS : Research and reconciliation with indigenous peoples in rural health journals
Lock, M., McMillan, F., Warne, D. K., Bennett, B., Kidd, J., Williams, N. G., Martire, J. L., Worley, P., Hutten‐Czapski, P., Saurman, E., et al. (2022) · Australian Journal of Rural Health · doi:10.1111/ajr.12905 · Cited by 11 · see citing works
Hollis, J., Deroover, K., Licata, M., Tully, B., Farragher, E., Lecathelinais, C., Bennett, N., Foster, M., Pennell, C. E., Wiggers, J. H., et al. (2024) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-06158-4 · Cited by 11 · see citing works
Maher, B., Guthrie, J., Sturgiss, E. A., Cargo, M., & Lovett, R. W. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-055304 · Cited by 11 · see citing works
Aboriginal Community Controlled Organisations Leading the Way in Child Health Research
Pickard, A., Stubbs, T., Carter, E., Rice, L. J., Thomas, S., Davies, J., Oscar, J., Martiniuk, A. L. C., & Elliott, E. J. (2025) · Journal of Community Health · doi:10.1007/s10900-024-01433-7 · Cited by 10 · see citing works
Bowker, S. L., Williams, K., Volk, A., Auger, L., Lafontaine, A. T., Dumont, P., Wingert, A., Davis, A., Bialy, L. M., Wright, E., et al. (2023) · Critical Care · doi:10.1186/s13054-023-04570-y · Cited by 10 · see citing works
Matsumoto, A., Blackburn, K., Spicer, B., Seear, K. H., & Johnson, C. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20064823 · Cited by 9 · see citing works
Walsh, C., Puszka, S., Markham, F., Barney, J., Yap, M., & Dreise, T. (2023) · Disability & Society · doi:10.1080/09687599.2023.2215395 · Cited by 9 · see citing works
Scholes-Robertson, N. J., Guha, C., Gutman, T., Howell, M., Yip, A., Cashmore, B. A., Roberts, I., Lopez‐Vargas, P. A., Wong, G., MacGinley, R., et al. (2024) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2024.111330 · Cited by 9 · see citing works
Islam, M. I., Sharwood, L. N., Chadwick, V. L., Esgin, T., & Martiniuk, A. L. C. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19159131 · Cited by 9 · see citing works
Riley, T., Cumming, B., Thandrayen, J., Meredith, A. L., Anderson, N. E., & Lovett, R. W. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20146416 · Cited by 9 · see citing works
d’Agincourt-Canning, L., Ziabakhsh, S., Morgan, J., Jinkerson-Brass, S., Joolaee, S., Smith, T., Loft, S., & Rosalie, D. (2023) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.13947 · Cited by 9 · see citing works
Andrews, S., Hamilton, B. E., & Humphreys, C. (2021) · Affilia · doi:10.1177/08861099211055520 · Cited by 9 · see citing works
Doran, C. M., Bryant, J., Langham, E., Bainbridge, R. G., Begg, S. J., & Potts, B. A. (2022) · Australian and New Zealand Journal of Public Health · doi:10.1111/1753-6405.13229 · Cited by 9 · see citing works
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Lock, M., McMillan, F., Warne, D. K., Bennett, B., Kidd, J., Williams, N. G., Martire, J. L., Worley, P. S., Hutten‐Czapski, P., Saurman, E., et al. (2022) · Rural and Remote Health · doi:10.22605/rrh7646 · Cited by 9 · see citing works
Mansell, E., Turnbull, D. A., Yung, A. R., Crumpen, S., Winkenweder, H., & Reilly, R. E. (2024) · Mental Health & Prevention · doi:10.1016/j.mhp.2024.200336 · Cited by 8 · see citing works
Goldberg, L. R., Radford, K. A., Smith, K., LoGiudice, D., Poulos, L., Baldock, D., Andersen, C., Charles, J., Canty, A. J., Bessarab, D. C., et al. (2025) · SSM - Mental Health · doi:10.1016/j.ssmmh.2025.100395 · Cited by 8 · see citing works
Ishaque, S., Ela, O., Dowling, A., Rissel, C. E., Canuto, K. J., Hall, K., Bidargaddi, N. P., Briley, A. L., Roberts, C. T., & Bonevski, B. (2025) · Journal of Medical Internet Research · doi:10.2196/57019 · Cited by 8 · see citing works
Self-citationSpringall, T. L., McLachlan, H., Forster, D. A., Browne, J., & Chamberlain, C. (2022) · Women and Birth · doi:10.1016/j.wombi.2022.06.012 · Cited by 8 · see citing works
- Authors
- Harfield, S., Pearson, O., Morey, K., Kite, E., Canuto, K., Glover, K., Gomersall, J. S., Carter, D., Davy, C., Aromataris, E., & Braunack-Mayer, A.
- Affiliations
- South Australian Health and Medical Research Institute (AU)
- The University of Adelaide (AU)
- Corresponding author
- Harfield, Stephen
- ORCID
- Venue
- BMC Medical Research Methodology
- Published
- 2020-04-10
- Volume
- 20
- Issue
- 1
- Pages
- 79-79
- ISSN
- 1471-2288 (ISSN-L)
- PMC
- PMC7147059
- OpenAlex
- W3015992259
- Cited by
- 313
- References
- 27
- Citations by year
- 2026: 40 · 2025: 56 · 2024: 70 · 2023: 56 · 2022: 50 · 2021: 33 · 2020: 7
- FWCI
- 20.21
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medical Research Methodology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ResearchOnline - JCU (James Cook University) (submittedVersion)
- Research Online (University of Wollongong) (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion)
- Funders
- National Health and Medical Research Council (NHMRC No 1061242)
- Topics
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Keywords
- Aboriginal and Torres Strait Islander health, Indigenous research paradigm, critical appraisal tools, research quality assessment, Indigenous epistemologies, community participation, community protocols, knowledge translation, capacity building, two-way learning
- MeSH terms
- Australian Aboriginal and Torres Strait Islander Peoples, Australia, Chronic Disease, Health Services Research, Health Services, Indigenous, Humans, Reproducibility of Results, Native Hawaiian or Other Pacific Islander
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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