Preventive care in general practice in Australia: a public health perspective

Family Health Clinics as a Source of Social Capital

PURPOSE

To examine the extent to which Family Health Clinics (FHCs) contribute to the formation of social capital among mothers, and determine whether it is influenced by socioeconomic factors. In FHCs, social capital can be gained by relationships between mothers (bonding social capital), by relationships between mothers and FHCs team, or between mothers of different origins/culture (bridging social capital) and health services institutional bodies (linking social capital).

DESIGN

This is a mixed method study. For the quantitative part, data were collected from 673 mothers using a questionnaire. The qualitative part was conducted with six focus groups.

RESULTS

The FHC constitutes a source of social capital in all dimensions. Bridging social capital was most prominent and is formed by interactions between mothers and FHC nurses. The factors that explain the formation of social capital were: mothers' spoken language being Arabic, participation in group training, and lower level of education. The focus groups revealed that participation in group training increased the social capital. Mothers noted that FHC nurses supplied updated information about their children's care. Regarding linking social capital, mothers perceive FHC nurses as mediators between them and the local and national health services.

CONCLUSIONS

FHC clinics are a source for gaining social capital. The FHC services should be adapted to mother's needs.

IMPLICATIONS

FHC nurses should try to create conditions for mothers to meet to create bonding social capital, relate to mother's needs for the creation of bridging social capital, and provide culturally adapted care for the formation of linking social capital.

Preventive Care in the Context of Men's Health

This study assessed the effectiveness of a health intervention, in diabetes education and risk assessment, to motivate men to take positive action, within the framework of the Health Belief Model. The worksite-based intervention targeted 525 men aged between 40 and 65 years from 27 organizations in the south-west of Western Australia in 1999/2000. Men identified as high risk were referred to their general practitioner. The adopted strategy had a number of strengths, namely that the health risk assessment was topic-specific, personalized, conducted on the worksite and combined with an educational component and a medical follow-up. The focus groups component of the study gave further understanding as to why the adopted strategy had been appropriate for men's needs.

Men's health promotion by general practitioners in a workplace setting

A project to promote men's health through diabetes education and screening was undertaken throughout rural industries in 1999/2000 in the south-west of Western Australia. Five hundred and twenty-five men aged 40-65 years participated from 27 industries. Sixty-four per cent of these men were identified at high-risk of developing diabetes and were referred to their general practitioner (GP) for follow-up. Seventy-six per cent of those at-risk visited their GP and hence the strategy adopted has been appropriate in engaging men in the preventive concept of seeking care, that is, getting them to attend their GP when they only have the risk factors but not the disease. However, men were left short of knowing how to achieve a change in their lifestyle behaviour and take appropriate action. Given the constraints of rural practice and the need to prioritise those with disease and gaps in service provision for both health services and GPs, there are two challenges: identifying those at-risk and modifying their behaviour.

Health lifestyle behaviour and socio-demographic characteristics. A study of Varna, Glasgow and Edinburgh

In this paper a lifestyle perspective is taken to study the various influences on four health related behaviours, i.e. cigarette smoking, diet behaviour, alcohol use and exercise. Of interest is how these behaviours are distributed over four socio-demographic indicators, i.e. the respondents gender, educational level, employment status and age. As a third factor the respondent's city of residence, Varna in Bulgaria and Glasgow and Edinburgh in Scotland, is taken into consideration. Data collected by telephone from 268 respondents from Varna, 827 respondents from Glasgow and 275 respondents from Edinburgh are considered. Large differences in the prevalence of health behaviours are found, with respondents in Varna behaving least healthily and respondents in Edinburgh behaving most healthily, and this is also true at sub-group level. Alcohol use is the exception, and here the opposite relationship between health behaviour and city of residence is found. Females generally behave more healthily than males, however, this pattern is not consistent for all health behaviours. Better educated and employed respondents behave in a more healthy way compared with less well educated and unemployed respondents and this is true in all three cities, with the difference being particularly large in Scotland. An 'economic' and a 'self-care' explanation are put forward to explain the patterns observed but both explanations are found wanting. It is proposed that integrating various theoretical models is necessary to further develop our understanding of health lifestyle behaviour.