Centre for Remote Health - Collected Works

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    Beyond therapy: the multiple benefits of using a service-learning model to enhance paediatric therapy in a remote area school. An evaluation of physiotherapy student placements at a school for children with additional needs in Central Australia, 2019
    (Flinders University, 2020) Beadle, Rosalind ; Farthing, Annie ;
    In 2019, physiotherapy students in their final year of university study provided two four-week blocks of intense physiotherapy services at Acacia Hill School (AHS) in Alice Springs. This school is the only education facility which caters specifically for children with additional needs in Central Australia. Of the 93 pupils at the school, 67% identify as Indigenous and 30% are in out of home care. These children are some of the nation’s most vulnerable. This service-learning placement emerged in response to a dearth of physiotherapy services for pupils and their families at AHS. A lack of government-funded resourcing combined with a problematic transition for many families onto the National Disability Insurance Scheme (NDIS) had resulted in some school-aged children with significant neuro-disability not having had access to critical physiotherapy for up to five years.
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    Ruralization of students’ horizons: insights into Australian health professional students’ rural and remote placements
    (Dove Press, 2018-01-31) Smith, Tony ; Cross, Merylin ; Waller, Susan ; Chambers, Helen ; Farthing, Annie ; Barraclough, Frances ; Pit, Sabrina W ; Sutton, Keith ; Muyambi, Kuda ; King, Stephanie ; Anderson, Jessie
    Introduction: Health workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students’ future rural practice intentions. Methods: Responses to open-ended survey questions from 3,204 students from multiple health professions and universities were analyzed using two independent methods applied concurrently: manual thematic analysis and computerized content analysis using Leximancer software. Results: The core concept identified from the thematic analysis was “ruralization of students’ horizons,” a construct representing the importance of preparing health professional students for practice in nonmetropolitan locations. Ruralization embodies three interrelated themes, “preparation and support,” “rural or remote health experience,” and “rural lifestyle and socialization,” each of which includes multiple subthemes. From the content analysis, factors that promoted students’ rural practice intentions were having a “positive” practice experience, interactions with “supportive staff,” and interactions with the “community” in general. It was apparent that “difficulties,” eg, with “accommodation,” “Internet” access, “transport,” and “financial” support, negatively impacted students’ placement experience and rural practice intentions. Conclusions: The study findings have policy and practice implications for continuing to support students undertaking regional, rural, and remote placements and preparing them for future practice in nonmetropolitan locations. This study may, therefore, further inform ongoing strategies for improving rural placement experiences and enhancing rural health workforce recruitment, retention, and capacity building.
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    Improving preventive health care in Aboriginal and Torres Strait Islander primary care settings
    (BioMed Central, 2017-03-23) Bailie, Jodie ; Matthews, Veronica ; Laycock, Alison ; Schultz, Rosalie ; Burgess, C Paul ; Peiris, David ; Larkins, Sarah ; Bailie, Ross Stewart
    Background Like other colonised populations, Indigenous Australians experience poorer health outcomes than non-Indigenous Australians. Preventable chronic disease is the largest contributor to the health differential between Indigenous and non-Indigenous Australians, but recommended best-practice preventive care is not consistently provided to Indigenous Australians. Significant improvement in health care delivery could be achieved through identifying and minimising evidence-practice gaps. Our objective was to use clinical audit data to create a framework of the priority evidence-practice gaps, strategies to address them, and drivers to support these strategies in the delivery of recommended preventive care. Methods De-identified preventive health clinical audit data from 137 primary health care (PHC) centres in five jurisdictions were analysed (n = 17,108 audited records of well adults with no documented major chronic disease; 367 system assessments; 2005–2014), together with stakeholder survey data relating to interpretation of these data, using a mixed-methods approach (n = 152 responses collated in 2015–16). Stakeholders surveyed included clinicians, managers, policy officers, continuous quality improvement (CQI) facilitators and academics. Priority evidence-practice gaps and associated barriers, enablers and strategies to address the gaps were identified and reported back through two-stages of consultation. Further analysis and interpretation of these data were used to develop a framework of strategies and drivers for health service improvement. Results Stakeholder identified priorities were: following-up abnormal test results; completing cardiovascular risk assessments; timely recording of results; recording enquiries about living conditions, family relationships and substance use; providing support for clients identified with emotional wellbeing risk; enhancing systems to enable team function and continuity of care. Drivers identified for improving care in these areas included: strong Indigenous participation in the PHC service; appropriate team structure and function to support preventive care; meaningful use of data to support quality of care and CQI; and corporate support functions and structures. Conclusion The framework should be useful for guiding development and implementation of barrier-driven, tailored interventions for primary health care service delivery and policy contexts, and for guiding further research. While specific strategies to improve the quality of preventive care need to be tailored to local context, these findings reinforce the requirement for multi-level action across the system. The framework and findings may be useful for similar purposes in other parts of the world, with appropriate attention to context in different locations.
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    Caring for country and the health of Aboriginal and Torres Strait Islander Australians
    (AMPCo Pty Ltd., 2017-07) Shultz, Rosalie ; Cairney, Sheree
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    Economies through Application of Nonmedical Primary-Preventative Health: Lessons from the Healthy Country Healthy People Experience of Australia’s Aboriginal People
    (MDPI, 2016) Campbell, David
    Abstract: TheWorld Health Organization reports noncommunicable disease as a global pandemic. While national and international health research/policy bodies, such as the World Health Organization and the Australian Institute of Health and Welfare, emphasize the importance of preventative health, there is a continuing distortion in the allocation of resources to curative health as a result of government failure. Government failure is, in part, the result of a political response to individual preference for certainty in receiving treatment for specific health conditions, rather than the uncertainty of population-based preventative intervention. This has led to a failure to engage with those primary causative factors affecting chronic disease, namely the psychosocial stressors, in which the socioeconomic determinants are an important component. Such causal factors are open to manipulation through government policies and joint government-government, government-private cooperation through application of nonmedical primary-preventative health policies. The health benefits of Aboriginal people in traditional land management, or caring-for-country, in remote to very remote Australia, is used to exemplify the social benefits of nonmedical primary-preventative health intervention. Such practices form part of the “healthy country, health people” concept that is traditionally relied upon by Indigenous peoples. Possible health and wider private good and public good social benefits are shown to occur across multiple disciplines and jurisdictions with the possibility of substantial economies. General principles in the application of nonmedical primary-preventative health activities are developed through consideration of the experience of Afboriginal people participation in traditional caring-for-country.