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Wells R, Claessen M, Dzidic P, Leitão S. The model of access to speech-language pathology services. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-12. [PMID: 38962971 DOI: 10.1080/17549507.2024.2363955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
PURPOSE Within Australia, some families face challenges in accessing paediatric speech-language pathology services. This research sought to investigate the factors that impact access to paediatric speech-language pathology services within Western Australia. METHOD Researchers used constructivist grounded theory to investigate the construct of access, as experienced and perceived by service decision-makers, namely caregivers of children with communication needs and speech-language pathologists who provide communication services. Eleven speech-language pathologists and 16 caregivers took part in 32 semi-structured in-depth interviews. Researchers used layers of coding of interviews transcripts and the constant comparative method to investigate data. RESULT Findings outline the factors that impact access to speech-language pathology services, as organised into the seven categories of the Model of Access to Speech-Language Pathology Services (MASPS). The categories and properties of this model are grounded within experiences and perspectives that participants contributed to the dataset. CONCLUSION MASPS provides a theoretical structure that has been constructed using inductive and abductive reasoning. This model can be used by service designers and decision-makers to reflect upon and improve experiences of service for a range of consumers. MASPS can also be used as a basis for further investigation into aspects of service access.
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Affiliation(s)
- Robert Wells
- Curtin School of Allied Health, Curtin University, Peth, Australia
- Curtin EnAble Institute, Curtin University, Peth, Australia
| | - Mary Claessen
- Curtin School of Allied Health, Curtin University, Peth, Australia
| | - Peta Dzidic
- Curtin School of Population Health, Curtin University, Peth, Australia, and
| | - Suze Leitão
- Curtin School of Allied Health, Curtin University, Peth, Australia
- Curtin EnAble Institute, Curtin University, Peth, Australia
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Kirk H, Spencer-Smith M, Jobson L, Nicolaou E, Cornish K, Melzak E, Hrysanidis C, Moriarty C, Davey B, Whyman T, Bird L, Bellgrove MA. A digital intervention to support childhood cognition after the COVID-19 pandemic: a pilot trial. Sci Rep 2024; 14:14065. [PMID: 38890384 PMCID: PMC11189556 DOI: 10.1038/s41598-024-63473-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 05/29/2024] [Indexed: 06/20/2024] Open
Abstract
Difficulties in executive functioning (EF) can result in impulsivity, forgetfulness, and inattention. Children living in remote/regional communities are particularly at risk of impairment in these cognitive skills due to reduced educational engagement and poorer access to interventions. This vulnerability has been exacerbated by the COVID-19 pandemic and strategies are needed to mitigate long-term negative impacts on EF. Here we propose a pilot trial investigating the benefits, feasibility, and acceptability of a school-based EF intervention for primary school students (6-8 years) living in regional, developmentally vulnerable, and socio-economically disadvantaged communities. Students were randomised to a digital intervention or teaching as usual, for 7 weeks. Children completed measures of EF and parents/educators completed ratings of everyday EF and social/emotional wellbeing at pre-intervention, post-intervention, and 3-month follow-up. Change in EFs (primary outcome), everyday EF, and social/emotional wellbeing (secondary outcomes) from pre- to post-intervention and pre-intervention to 3-month follow-up were examined. Feasibility and acceptability of the intervention was assessed through educator feedback and intervention adherence.Protocol Registration: The stage 1 protocol for this Registered Report was accepted in principle on 20 April 2023. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/WT3S2 . The approved Stage 1 protocol is available here: https://osf.io/kzfwn .
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Affiliation(s)
- Hannah Kirk
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia.
| | - Megan Spencer-Smith
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Laura Jobson
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Elizabeth Nicolaou
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Kim Cornish
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Ebony Melzak
- Faculty of Education, Monash University, Melbourne, VIC, Australia
| | - Caitlin Hrysanidis
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Cassie Moriarty
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Belinda Davey
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Theoni Whyman
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Laura Bird
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Mark A Bellgrove
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
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3
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Dadi AF, He V, Brown K, Hazell-Raine K, Reilly N, Giallo R, Rae KM, Hazell P, Guthridge S. Association between maternal mental health-related hospitalisation in the 5 years prior to or during pregnancy and adverse birth outcomes: a population-based retrospective cohort data linkage study in the Northern Territory of Australia. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 46:101063. [PMID: 38659431 PMCID: PMC11040136 DOI: 10.1016/j.lanwpc.2024.101063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/13/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024]
Abstract
Background Mental health conditions prior to or during pregnancy that are not addressed can have adverse consequences for pregnancy and birth outcomes. This study aimed to determine the extent to which women's mental health-related hospitalisation (MHrH) prior to or during pregnancy was associated with a risk of adverse birth outcomes. Methods We linked the perinatal data register for all births in the Northern Territory, Australia, from the year 1999 to 2017, to hospital admissions records to create a cohort of births to women aged 15-44 years with and without MHrH prior to or during pregnancy. We used Modified Poisson Regression and Latent Class Analysis to assess the association between maternal MHrH and adverse birth outcomes (i.e., stillbirth, preterm birth, low birth weight, and short birth length). We explored a mediation effect of covariates on theoretical causal paths. We calculated the adjusted Population Attributable Fraction (PAF) and Preventive Fractions for the Population (PFP) for valid associations. Findings From 72,518 births, 70,425 births (36.4% for Aboriginal women) were included in the analysis. The Latent Class Analys identified two classes: high (membership probability of 10.5%) and low adverse birth outcomes. Births to Aboriginal women with MHrH were around two times more likely to be in the class of high adverse birth outcomes. MHrH prior to or during pregnancy increased the risk of all adverse birth outcomes in both populations with risk ranging from 1.19 (95% CI: 1.05, 1.35) to 7.89 (1.17, 53.37). Eight or more antenatal care visits and intrauterine growth restriction mostly played a significant mediation role between maternal MHrH and adverse birth outcomes with mediation effects ranging from 1.04 (1.01, 1.08) to 1.39 (1.14, 1.69). MHrH had a low to high population impact with a PAF ranging from 16.1% (5.1%, 25.7%) to 87.3% (14.3%, 98.1%). Eight or above antenatal care visits avert extra adverse birth outcomes that range from 723 (332-765) stillbirths to 3003 (1972-4434) preterm births. Interpretation Maternal MHrH is a modifiable risk factor that explained a low to moderate risk of adverse birth outcomes in the Northern Territory. The knowledge highlights the need for the development and implementation of preconception mental health care into routine health services. Funding The Child and Youth Development Research Partnership (CYDRP) data repository is supported by a grant from the Northern Territory Government.
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Affiliation(s)
- Abel Fekadu Dadi
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Vincent He
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Kiarna Brown
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Royal Darwin Hospital, Tiwi, NT 0810, Australia
| | - Karen Hazell-Raine
- Faculty of Health, Charles Darwin University, Darwin, Australia
- Faculty of Medicine and Health, The University of Sydney, Australia
| | - Nicole Reilly
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Sydney and St John of God Burwood Hospital, Sydney, Australia
- Faculty of Science, Medicine and Health, Graduate School of Medicine, University of Wollongong, Australia
| | - Rebecca Giallo
- Faculty of Health, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Kym M. Rae
- Mater Research Institute, Aubigny Place, Raymond Terrace, South Brisbane, QLD, Australia
| | - Philip Hazell
- School of Medicine, Charles Darwin University, Australia
- School of Medicine, The University of Sydney, Australia
| | - Steven Guthridge
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
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Raza MA, Aziz S, Iftikhar D, Anjum I, Fialova D. Addressing quality medication use among migrant patients: Establishment of an organization to provide culturally competent medication care. Saudi Pharm J 2024; 32:101922. [PMID: 38318317 PMCID: PMC10840353 DOI: 10.1016/j.jsps.2023.101922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/12/2023] [Indexed: 02/07/2024] Open
Abstract
As the global landscape continues to witness an increase in migration, the healthcare community faces an evolving challenge: the provision of quality medication care to migrant patients. Language barriers, cultural differences, and a lack of understanding of the local healthcare system can often impede the effective management of medications and access to healthcare services among migrant populations. Pharmacists, as medication experts, are dignified to make a substantial impact in bridging the gap between migrants and quality healthcare. Their expertise in medication management, accessibility, and counseling positions them as critical healthcare providers for this patient population. Pharmacies and pharmacists can serve as trusted hubs where migrants receive not only essential medications but also culturally sensitive support in navigating the healthcare system. This commentary article highlights the critical importance of culturally competent medication care for migrant patients and the central role that pharmacists can play in this endeavor. By establishing organization dedicated to this cause lead by pharmacists, we can not only address an urgent healthcare concern but also set a precedent for a healthcare system that values inclusivity, cultural competence, and equitable access to quality medication care for all, regardless of their cultural background.
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Affiliation(s)
- Muhammad Ahmer Raza
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic
| | - Shireen Aziz
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic
| | | | - Irfan Anjum
- Department of Basic Medical Sciences, Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Daniela Fialova
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic
- Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
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Yadav UN, Smith M, Agostino J, Sinka V, Williamson L, Wyber R, Butler DC, Belfrage M, Freeman K, Passey M, Walke E, Hammond B, Lovett R, Douglas KA. Understanding the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australia: a realist review protocol. BMJ Open 2023; 13:e071234. [PMID: 37344121 DOI: 10.1136/bmjopen-2022-071234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
INTRODUCTION Chronic disease remains the leading cause of morbidity and mortality among Aboriginal and Torres Strait Islander peoples in Australia. Regular structured, comprehensive health assessments are available to Aboriginal and Torres Strait Islander people as annual health checks funded through the Medicare Benefits Schedule. This realist review aims to identify context-specific enablers and tensions and contribute to developing an evidence framework to guide the implementation of health checks in the prevention and early detection of chronic diseases for Aboriginal and Torres Strait Islander people. METHODS AND ANALYSIS The review will involve the following steps: (1) Aboriginal and Torres Strait Islander engagement and research governance; (2) defining the scope of the review; (3) search strategy; (4) screening, study selection and appraisal; (5) data extraction and organisation of evidence; (6) data synthesis and drawing conclusions. This realist review will follow the Realist and MEta-narrative Evidence Syntheses: Evolving Standards guidance and will be reported as set up by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement. The realist programme theory will be developed through a literature review using multiple database searches from 1 November 1999 to 31 June 2022, limited to the English language, and stakeholder consultation, which will be refined throughout the review process. The study findings will be reported by applying the context-mechanism-outcome configuration to gain a deeper understanding of context and underlying mechanisms that influence the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australia. ETHICS AND DISSEMINATION Ethical approval is not required as this review will be using secondary data. Findings will be published in a peer-reviewed journal and presented at scientific conferences. SYSTEMATIC REVIEW REGISTRATION The review protocol has been registered on the international prospective register of systematic reviews: CRD42022326697.
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Affiliation(s)
- Uday Narayan Yadav
- National Centre for Aborginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Matthew Smith
- Australian National University Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Jason Agostino
- Australian National University Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
- National Aboriginal Community Controlled Health Organisation, Canberra, Australian Capital Territory, Australia
| | - Victoria Sinka
- Centre for Kidney Research, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Leonie Williamson
- National Centre for Aborginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Rosemary Wyber
- National Centre for Aborginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Danielle C Butler
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- The Institute for Urban Indigenous Health, Windsor, Queensland, Australia
| | - Mary Belfrage
- Royal Australian College of General Practitioners, Aboriginal & Torres Strait Islander Health, Melbourne, Victoria, Australia
| | - Kate Freeman
- Royal Australian College of General Practitioners, Aboriginal & Torres Strait Islander Health, Melbourne, Victoria, Australia
| | - Megan Passey
- University Centre for Rural Health, University of Sydney, Lismore, New South Wales, Australia
| | - Emma Walke
- University Centre for Rural Health, University of Sydney, Lismore, New South Wales, Australia
| | - Belinda Hammond
- Royal Australian College of General Practitioners, Aboriginal & Torres Strait Islander Health, Melbourne, Victoria, Australia
| | - Raymond Lovett
- National Centre for Aborginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kirsty A Douglas
- Australian National University Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
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6
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Saxby K, Byrnes J, de New SC, Nghiem S, Petrie D. Does affirmative action reduce disparities in healthcare use by Indigenous peoples? Evidence from Australia's Indigenous Practice Incentives Program. HEALTH ECONOMICS 2023; 32:853-872. [PMID: 36609870 DOI: 10.1002/hec.4645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Globally, Indigenous populations experience poorer health but use less primary healthcare than their non-Indigenous counterparts. In 2010, the Australian government introduced a targeted reform aimed at reducing these disparities. The reform reduced, or abolished prescription medicine co-payments and provided financial incentives for GPs to better manage chronic disease care for Indigenous peoples. Exploiting the framework of a natural experiment, we investigate how the reform affected these health disparities in primary and specialist healthcare utilization using longitudinal administrative data from 75,826 Australians, including 1896 Indigenous peoples, with cardiovascular disease. The differences-in-differences estimates indicate that the reform increased primary healthcare use among Indigenous peoples, including 12.9% more prescription medicines, 6.6% more GP services, and 34.0% more chronic disease services, but also reduced specialist attendances by 11.8%. Increases in primary care were larger for those who received the largest co-payment relief and lived in metropolitan regions, whereas the reduction in specialist attendances was concentrated among lower income Indigenous patients. Affirmative action can reduce inequalities in Indigenous use of primary healthcare, albeit careful design is required to ensure that benefits are equitable and do not lead to substitution away from valuable, or necessary, care.
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Affiliation(s)
- Karinna Saxby
- Centre for Health Economics, Monash Business School, Monash University, Victoria, Caulfield East, Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics, Griffith University, Queensland, Nathan, Australia
| | - Sonja C de New
- Centre for Health Economics, Monash Business School, Monash University, Victoria, Caulfield East, Australia
- Institute for the Study of Labor (IZA Bonn), RWI Research Network, Essen, Germany
| | - Son Nghiem
- College of Health & Medicine, Australian National University, Australian Capital Territory, Canberra, Australia
| | - Dennis Petrie
- Centre for Health Economics, Monash Business School, Monash University, Victoria, Caulfield East, Australia
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7
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Naidoo T, Chamunyonga C, Burbery J, Rutledge P. Identifying methods to best integrate indigenous knowledge and perspectives within the radiation therapy undergraduate curriculum. J Med Radiat Sci 2023. [PMID: 36781205 DOI: 10.1002/jmrs.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/24/2023] [Indexed: 02/15/2023] Open
Abstract
The Australian healthcare system continues to work towards close the gap to improve and achieve equality in health and life expectancy for Aboriginal and Torres Strait Islander peoples. When culturally safe practice is forefront, it may be the driving force in improving Indigenous Australian healthcare outcomes. For students and practitioners to be equipped with the industry-required cultural safety skills, we believe Indigenous Australian knowledge and perspectives must be effectively integrated into undergraduate education. A scoping review of the literature was conducted to identify the most effective teaching and learning methods and assessment tools to best integrate Indigenous knowledge and perspectives into undergraduate radiation therapy curriculum at Queensland University of Technology (QUT). Embase, CINAHL, Scopus and PubMed-Medline were searched to access peer-reviewed studies published between 2017 and 2022. A total of 591 articles were identified with 39 full-text articles meeting the inclusion criteria. Methods of teaching and learning and independent assessment tools that promote cultural capability in undergraduate education were identified. Findings included intensive patient-specific workshops, which were reported to provide students with an immersive learning experience, better preparing them for clinical placements and future practice. Additionally, other allied healthcare professions have utilised tools such as the Cultural Capability Management Tool (CCMT) and Trans-Cultural Self-Efficacy Tool (TSET) to quantitatively assess positive shifts and highlight developmental needs. These findings will inform current educational endeavours to promote cultural safety and the cultural capability continuum in the undergraduate radiation therapy curriculum.
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Affiliation(s)
- Thashmira Naidoo
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Radiation Oncology Princess Alexandra Hospital Raymond Terrace, South Brisbane, Queensland, Australia
| | - Crispen Chamunyonga
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Julie Burbery
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Peta Rutledge
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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8
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Brockie T, Clark TC, Best O, Power T, Bourque Bearskin L, Kurtz DLM, Lowe J, Wilson D. Indigenous social exclusion to inclusion: Case studies on Indigenous nursing leadership in four high income countries. J Clin Nurs 2023; 32:610-624. [PMID: 33942940 DOI: 10.1111/jocn.15801] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/21/2021] [Accepted: 03/29/2021] [Indexed: 01/17/2023]
Abstract
AIMS AND OBJECTIVES This discursive paper provides a call to action from an international collective of Indigenous nurse academics from Australia, Canada, Aotearoa New Zealand and the USA, for nurses to be allies in supporting policies and resources necessary to equitably promote Indigenous health outcomes. BACKGROUND Indigenous Peoples with experiences of colonisation have poorer health compared to other groups, as health systems have failed to address their needs and preferences. Achieving health equity will require leadership from Indigenous nurses to develop and implement new systems of care delivery. However, little is known about how Indigenous nurses influence health systems as levers for change. DESIGN A Kaupapa Māori case study design. METHODS Using a Kaupapa Māori case study methodology, coupled with expert Indigenous nursing knowledge, we developed a consensus on key themes. Themes were derived from three questions posed across the four countries. Themes were collated to illustrate how Indigenous nurses have provided nursing leadership to redress colonial injustices, contribute to models of care and enhance the Indigenous workforce. RESULTS These case studies highlight Indigenous nurses provide strong leadership to influence outcomes for Indigenous Peoples. Five strategies were noted across the four countries: (1) Indigenous nationhood and reconciliation as levers for change, (2) Indigenous nursing leadership, (3) Indigenous workforce strategies, (4) Development of culturally safe practice and Indigenous models of care and (5) Indigenous nurse activism. CONCLUSIONS In light of 2020 declared International Year of the Nurse and Midwife, we assert Indigenous nurses' work must be visible to support development of strategic approaches for improving health outcomes, including resources for workforce expansion and for implementing new care models. RELEVANCE TO CLINICAL PRACTICE Curating strategies to promote Indigenous nurse leaders around the world is essential for improving models of healthcare delivery and health outcomes for Indigenous Peoples.
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Affiliation(s)
- Teresa Brockie
- Johns Hopkins University School of Nursing, Baltimore, MD, USA.,Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Baltimore, MD, USA
| | | | - Odette Best
- University of Southern Queensland - Ipswich Campus, Ipswich, Qld, Australia
| | - Tamara Power
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW, Australia
| | | | - Donna L M Kurtz
- University of British Columbia School of Nursing, Vancouver, BC, Canada
| | - John Lowe
- University of Texas at Austin School of Nursing, Austin, TX, USA
| | - Denise Wilson
- Faculty of Health and Environmental Sciences, Taupua Waiora Māori Research Centre, Auckland University of Technology, Auckland, New Zealand
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9
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Chew CC, Ibrahim HA, Balan VK, Abd-Aziz NA, Puah HM, Hss AS. Growth management and prevalence of underweight of indigenous children (Orang Asli) in Peninsular Malaysia: a clinical audit. BMC Pediatr 2022; 22:481. [PMID: 35948912 PMCID: PMC9364563 DOI: 10.1186/s12887-022-03532-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background Most indigenous people (Orang Asli in Peninsular Malaysia) live in poverty, and their children are at risk of growth problems due to nutrition deficiency. Routine health and growth assessments are essential to identify these children. This clinical audit aimed to determine the growth management of indigenous children and the prevalence of underweight among these children in Perak state, Malaysia. Methods A clinical audit was conducted in 2016 after obtaining consensus from stakeholders for audit criteria, forms, and procedures. All weight-for-age growth charts of Orang Asli children aged 2 and below were sampled for retrospective audit. This audit excluded children who required special needs. Growth charts were examined against audit criteria: (i) quality of growth chart plotting (charts were not plotted, incompletely plotted, or incorrectly plotted), (ii) presence of underweight, and (iii) appropriateness of action taken (appropriate or inappropriate action) according to local standard operating policies. Eligible auditors were first trained using simulated growth charts. Results Out of 1329 growth charts audited, 797 (60%) growth charts were correctly plotted, 527 (39.7%) were incompletely or incorrectly plotted, and five (0.3%) were not plotted. Overall, 40.0% of the growth chart was plotted incorrectly or completely not plotted. 550 (41.4%) children were found to be underweight, and 71.5% of them received inappropriate care management. Where growth charts were correctly plotted, 283 children were identified with underweight problems, and 194 (68.6%) of them received inappropriate care. For growth charts that were plotted incompletely or incorrectly, 267 children were identified as having underweight problems, and 199 (74.5%) received inappropriate care. The growth status of 265 (19.9%) children was unable to be determined due to incomplete plotting. Conclusion Approximately 40% of indigenous Orang Asli children aged 2 years and under were underweight, and most of them received inappropriate care.
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Affiliation(s)
- Chii-Chii Chew
- Clinical Research Centre Perak, Hospital Raja Permaisuri Bainun, Ministry of Health, Level 4, Ambulatory Care Centre (ACC), Jalan Raja Ashman Shah, 30450, Ipoh, Perak, Malaysia.
| | - Hasni-Adha Ibrahim
- Clinical Research Centre Perak, Hospital Raja Permaisuri Bainun, Ministry of Health, Level 4, Ambulatory Care Centre (ACC), Jalan Raja Ashman Shah, 30450, Ipoh, Perak, Malaysia
| | - Venugopalan K Balan
- Perak State Health Department, Ministry of Health, 30000, Ipoh, Perak, Malaysia
| | - Nor-Azizah Abd-Aziz
- Perak State Health Department, Ministry of Health, 30000, Ipoh, Perak, Malaysia
| | - Hooi-Meng Puah
- Perak State Health Department, Ministry of Health, 30000, Ipoh, Perak, Malaysia
| | - Amar-Singh Hss
- Clinical Research Centre Perak, Hospital Raja Permaisuri Bainun, Ministry of Health, Level 4, Ambulatory Care Centre (ACC), Jalan Raja Ashman Shah, 30450, Ipoh, Perak, Malaysia.,Paediatric Department, Hospital Raja Permaisuri Bainun, Ministry of Health, Jalan Raja Ashman Shah, 30450, Ipoh, Perak, Malaysia
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10
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Chew CC, Lim XJ, Low LL, Lau KM, Kari M, Shamsudin UK, Rajan P. The challenges in managing the growth of indigenous children in Perak State, Malaysia: A qualitative study. PLoS One 2022; 17:e0265917. [PMID: 35320328 PMCID: PMC8942260 DOI: 10.1371/journal.pone.0265917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/09/2022] [Indexed: 11/25/2022] Open
Abstract
Indigenous peoples in Peninsular Malaysia, known as Orang Asli, have been associated with the problem of malnutrition. Approximately 40% of their children are underweight. Indigenous peoples' distinct social, cultural, and economic traits, which differ from those of the dominant communities in which they live, may pose significant challenges for health care providers (HCPs) in addressing the malnutrition issue. This study explores challenges encountered by HCPs, with at least six months of experience in monitoring the growth parameters of Orang Asli children residing in Perak State in Peninsular Malaysia. A cross-sectional study was conducted between December 2020 and June 2021, involving three focus group discussions and three in-depth interviews. Thematic analysis was used. A total of 19 participants (6 nurses, 5 nursing managers, 4 medical officers, 2 nutritionists, a family medicine specialist, and a paediatrician) took part in this study. The challenges were summarized into four themes: (I) accessibility to nutrition, (II) accessibility to healthcare services, (II) skills of HCPs, and (IV) challenges of implementing nutrition programs. The inability of the Orang Asli children to access nutritious food was due to poverty, different perceptions of life priorities, and the practice of food taboos among the communities. Inadequate infrastructure and transportation discourage parents from bringing their children to healthcare facilities. The belief in and preference for traditional healing, the practice of semi-nomadic lifestyles, and fear of HCPs and their timid nature were factors that prevented Orang Asli children from accessing healthcare services. HCPs need to equip themselves with cross-cultural communication and interaction skills and adapt their skills to environmental challenges to overcome unexpected encounters in mobile clinics. The non-exposed food items, the risk of food basket sharing with other family members, and community feeding programs' coordination were the challenges to be addressed when implementing nutrition programmes for Orang Asli children. The challenges of HCPs are multifactorial and require a multifaceted approach. There is a need for joint efforts of stakeholders, from communities and non-governmental organisations (NGOs) to the health authorities, to address the challenges of HCPs.
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Affiliation(s)
- Chii-Chii Chew
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh, Malaysia
| | - Xin-Jie Lim
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh, Malaysia
| | - Lee-Lan Low
- Institute for Health Systems Research, Ministry of Health, Ipoh, Malaysia
| | - Kin-Mun Lau
- Perak State Health Department, Ministry of Health, Ipoh, Ipoh, Malaysia
| | - Maziana Kari
- Perak State Health Department, Ministry of Health, Ipoh, Ipoh, Malaysia
| | | | - Philip Rajan
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh, Malaysia
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11
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Beer K, Gentgall M, Templeton N, Whitehouse C, Straiton N. Who's included? The role of the Clinical Research Nurse in enabling research participation for under-represented and under-served groups. J Res Nurs 2022; 27:143-154. [PMID: 35392191 PMCID: PMC8980581 DOI: 10.1177/17449871221077076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background There is a global call for more inclusive clinical research that is representative of all populations, particularly those historically under-represented or under-served. A lack of broad representation results in disproportionate health outcomes and limits the applicability and translation of research findings. Aim Identify and describe barriers to participation across the research lifecycle and consider the role of the Clinical Research Nurse (CRN) in promoting inclusivity, including for Aboriginal and Torres Strait Islander Peoples within Australia. Discussion Review of recent literature and best practice identified barriers to research participation across the research process; at system, participant and practitioner levels. This discussion paper explores the role of the CRN; acting as enablers, facilitators and navigators, to mitigate participation barriers. Conclusion With their comprehensive understanding of the research process, clinical care pathways, reflective practices and participant-centred approaches, CRNs are uniquely positioned to advocate for greater equity in access to clinical research and to motivate stakeholders across the research enterprise to embed inclusive approaches in the design, conduct and dissemination of research. Implications for Practice An in-depth understanding of the research process, self, and cultural norms of the populations they serve is essential for CRNs to effectively advocate for equity in access to research.
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Affiliation(s)
- Kelly Beer
- Kelly Beer, Perron Institute for Neurological and Translational Science; Murdoch University, Building 390, Discovery Way, Murdoch, WA 6150, Australia.
| | - Melanie Gentgall
- Clinical Research Nurse, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | | | - Claire Whitehouse
- Senior Nurse for Nursing, Midwifery and Allied Health Professions Research, The James Paget University Hospitals NHS Foundation Trust, Norfolk, UK
| | - Nicola Straiton
- Registered Nurse, Faculty of Medicine and Health, University of Sydney, NSW, Australia
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12
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Preisz P, Preisz A, Daley S, Jazayeri F. 'Dalarinji': A flexible clinic, belonging to and for the Aboriginal people, in an Australian emergency department. Emerg Med Australas 2022; 34:46-51. [PMID: 34312988 DOI: 10.1111/1742-6723.13833] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 06/29/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Equity and access to high-quality healthcare for Aboriginal and Torres Strait Islander (Aboriginal) people has remained refractory for complex and multifactorial reasons, and there are sound ethical arguments for addressing this urgently. In EDs all patients who 'leave at own risk' (LAOR) or 'do not wait to be seen' (DNW) are at increased risk of readmission, morbidity or death. This also incurs additional resource costs to the health system. Aboriginal patients have high rates of DNW and LAOR. The Flexiclinic model of care was co-designed to better support the needs of Aboriginal patients in the ED and to reduce the rates of DNW and LAOR. METHODS 'Dalarinji', or Flexiclinic, is a flexible model of care within the ED collaboratively devised with the Aboriginal Health Unit to address the major factors that influence this vulnerable cohort leaving the St Vincent's Hospital ED (SVHED) prior to being assessed or before completion of treatment. RESULTS In the 3 months since its introduction, the Flexiclinic approach has significantly improved the quality and equity of access to medical care at SVHED for Aboriginal patients with the average summed rate of DNW and LAOR falling to 5.2% of presentations, representing a fivefold decrease in the probability of Aboriginal patients receiving incomplete care. CONCLUSION The Flexiclinic approach has significantly improved medical care at SVHED for Aboriginal patients. It has been well received by both staff and patients and has had no adverse effects on delivery of services to other patient groups.
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Affiliation(s)
- Paul Preisz
- Emergency Department, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
| | - Anne Preisz
- Sydney Health Ethics, Faculty of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Clinical Ethics Service, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
- School of Medicine, The University of Notre Dame Australia, Sydney, New South Wales, Australia
| | - Scott Daley
- Emergency Department, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
| | - Farzad Jazayeri
- Emergency Department, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
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13
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O’Brien P, Conley B, Bunzli S, Bullen J, Coffin J, Persaud J, Gunatillake T, Dowsey MM, Choong PF, Lin I. Staying moving, staying strong: Protocol for developing culturally appropriate information for Aboriginal people with osteoarthritis, rheumatoid arthritis, lupus and gout. PLoS One 2021; 16:e0261670. [PMID: 34941954 PMCID: PMC8699613 DOI: 10.1371/journal.pone.0261670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 12/07/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Addressing disparities in arthritis care is an important yet unmet health need for Aboriginal and Torres Strait Islander people in Australia (respectfully Aboriginal people herewith). Despite the significant prevalence and burden of arthritis within Aboriginal communities, access to care for arthritis is low. One means to reduce existing disparities in health care is to address current challenges relating to the appropriateness and acceptability of health care information resources for Aboriginal people. Health information sources can help to empower patients and their families to have greater involvement in their care and to engage in self-management of their condition. Despite an extensive range of arthritis information resources being available, currently no resources have been culturally adapted and developed in collaboration with Aboriginal consumers with arthritis. This paper outlines the processes that will be undertaken within the Staying Moving, Staying Strong project. This project aims to develop culturally secure arthritis information for Aboriginal people with osteoarthritis, rheumatoid arthritis, lupus and gout. Methods and analysis The overarching principle guiding this project is cultural security, referring to the incorporation of processes such that the research will not compromise the cultural rights, values and expectations of Aboriginal people. This project will prioritise partnerships, community engagement, community benefit, sustainability, transferability, and capacity building and therefore uphold the cultural rights and values of Aboriginal people. In this six-phase project we will; 1) Establish a community reference group and advisory committee; 2) Explore the health information needs and preferences of Aboriginal people with arthritis; 3) Synthesise the existing key recommendations in high quality clinical practice guidelines on arthritis care; 4) Culturally adapt key clinical recommendations; 5) Develop culturally appropriate arthritis resources and; 6) Qualitatively evaluate the developed resources.
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Affiliation(s)
- Penny O’Brien
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Brooke Conley
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
- * E-mail:
| | - Samantha Bunzli
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Jonathan Bullen
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Juli Coffin
- Telethon Kids Institute, Broome, WA, Australia
| | - Jennifer Persaud
- Arthritis and Osteoporosis Western Australia, Perth, WA, Australia
- Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Tilini Gunatillake
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Michelle M. Dowsey
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Peter F. Choong
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Ivan Lin
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, WA, Australia
- Geraldton Regional Aboriginal Medical Service, Geraldton, WA, Australia
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Ullah S, Guoqiang H, Khan U, Niazi K. State, religion and the marginalisation of traditional healing in Gwadar, Pakistan. MEDICAL HUMANITIES 2020; 46:444-453. [PMID: 31992584 DOI: 10.1136/medhum-2019-011747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/04/2019] [Indexed: 06/10/2023]
Abstract
This ethnographic encounter explores suppression and domination faced by traditional health seekers in Gwadar, Pakistan. The study aimed to provide an insight into the ways in which practicing traditional healthcare becomes a challenge when it conflicts with the assimilationist project of the state. Qualitative research methods, including in-depth interviews and participant observation, were used to collect data on the encounters of traditional health seekers with the state and dominant religion. The findings show that traditional health seeking behaviour was stereotyped as non-civilised and archaic by medical staff, and labelled as non-religious, and thus, suppressed by radical Islamist groups and other state apparatuses. This situation has further negative effects on the health of traditional health seekers as the national healthcare system does not efficiently provide the services required by this population. State laws, a general environment of fear, and threats have led this population to legal consciousness and contextual awareness; they have further adopted multiple resistance strategies to navigate and circumvent oppressive laws and domination in order to follow their traditional healthcare practices. This study suggests that national cosmopolitan healthcare services provided to the fishing community should be tailored to and not suppress the culturally specific health needs of that population. Members of the fishing community should not be compelled to abstain from their traditional healthcare and health-seeking behaviours; traditional healthcare practices should be merged with cosmopolitan ones in order to address the sociocultural issues and meet the health needs of this marginalised population.
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Affiliation(s)
- Shakir Ullah
- Anthropology, Sun Yat-Sen University, Guangzhou, China
| | - He Guoqiang
- Anthropology, Sun Yat-Sen University, Guangzhou, China
| | - Usman Khan
- Anthropology, Sun Yat-Sen University, Guangzhou, China
| | - Komal Niazi
- Anthropology, Sun Yat-Sen University, Guangzhou, China
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15
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Gould GS, Holder C, Oldmeadow C, Gruppetta M. Supports Used by Aboriginal and Torres Strait Islander Women for Their Health, including Smoking Cessation, and a Baby's Health: A Cross-Sectional Survey in New South Wales, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217766. [PMID: 33114142 PMCID: PMC7660307 DOI: 10.3390/ijerph17217766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 12/16/2022]
Abstract
This study explored Aboriginal and Torres Strait Islander women’s use of supports for their general health, for smoking cessation, and the health of babies or children, and analyzed the women’s predictors for seeking types of support. Aboriginal and Torres Strait Islander women were recruited for a cross-sectional survey in two regions of NSW N = 132. The 19-item survey questioned the likelihood that the participant would use the various supports for their health, to quit smoking, and for a baby or child’s health. Logistic regression analyses were performed on N = 98 with complete data. Older participants were less likely to use Facebook or the internet for their health, or the health of a child, but were more likely to consult with health professionals. Women who had quit smoking were less likely to use an app for their health compared to smokers. Women who had a child living in their household were less likely to use the internet for a child’s health. This community-based study revealed age-related differences for access to health services and differences according to smoking status. Patterns of internet and app use warrant further consideration when planning strategies to improve Aboriginal and Torres Strait Islander women and children’s health.
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Affiliation(s)
- Gillian S. Gould
- School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, Australia;
- Hunter Medical Research Institute, New Lambton Heights 2305, Australia; (C.H.); (C.O.)
- Correspondence: ; Tel.: +61-40-361-5563
| | - Carl Holder
- Hunter Medical Research Institute, New Lambton Heights 2305, Australia; (C.H.); (C.O.)
| | - Christopher Oldmeadow
- Hunter Medical Research Institute, New Lambton Heights 2305, Australia; (C.H.); (C.O.)
| | - Maree Gruppetta
- School of Medicine and Public Health, The University of Newcastle, Callaghan 2308, Australia;
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16
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Pulok MH, van Gool K, Hall J. Inequity in healthcare use among the indigenous population living in non-remote areas of Australia. Public Health 2020; 186:35-43. [PMID: 32768622 DOI: 10.1016/j.puhe.2020.06.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/10/2020] [Accepted: 06/24/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Although several studies have examined the gap in healthcare use between indigenous and non-indigenous people, empirical evidence on inequity in healthcare use within indigenous populations is limited. This study aims to fill this gap in the literature by investigating income-related inequity (unequal use for equal need) in healthcare use among indigenous Australians living in non-remote areas. STUDY DESIGN This is a cross-sectional study. METHODS This study used data from the Australian Aboriginal and Torres Strait Islander Health Survey, 2012-13. Logistic regression analysis was used to determine the association of income with the probability of a general practitioner (GP) visit, a specialist visit and inpatient admission. The horizontal inequity (HI) index and decomposition analysis were also used to quantify and explain inequity in healthcare use. RESULTS No consistent association was found between income and the probability of GP visit or inpatient admission after controlling for health need. However, the likelihood of visiting a specialist was about three times (odds ratio = 2.96, P = 0.028) higher for the richest compared with the poorest population subgroups. The inequity index was 0.016 (P < 0.001), indicating a pro-rich inequity for the probability of visiting a specialist. Income inequality, unequal distribution of private health insurance and inequality in education were the main factors explaining the pro-rich inequity in specialist utilisation. CONCLUSIONS Although there was no income-related inequity in GP visits or inpatient admissions, wealthier indigenous Australians had a higher probability of visiting a specialist than their poorer counterparts, after adjusting for need. Specific policies and initiatives are required to address the inequity faced by low-income indigenous people in Australia.
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Affiliation(s)
- M H Pulok
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), NSW, Australia; Nova Scotia Health Authority, Halifax, NS, Canada.
| | - K van Gool
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), NSW, Australia
| | - J Hall
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), NSW, Australia
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Shukla N, Pradhan B, Dikshit A, Chakraborty S, Alamri AM. A Review of Models Used for Investigating Barriers to Healthcare Access in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4087. [PMID: 32521710 PMCID: PMC7312585 DOI: 10.3390/ijerph17114087] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/28/2020] [Accepted: 06/05/2020] [Indexed: 11/16/2022]
Abstract
Understanding barriers to healthcare access is a multifaceted challenge, which is often highly diverse depending on location and the prevalent surroundings. The barriers can range from transport accessibility to socio-economic conditions, ethnicity and various patient characteristics. Australia has one of the best healthcare systems in the world; however, there are several concerns surrounding its accessibility, primarily due to the vast geographical area it encompasses. This review study is an attempt to understand the various modeling approaches used by researchers to analyze diverse barriers related to specific disease types and the various areal distributions in the country. In terms of barriers, the most affected people are those living in rural and remote parts, and the situation is even worse for indigenous people. These models have mostly focused on the use of statistical models and spatial modeling. The review reveals that most of the focus has been on cancer-related studies and understanding accessibility among the rural and urban population. Future work should focus on further categorizing the population based on indigeneity, migration status and the use of advanced computational models. This article should not be considered an exhaustive review of every aspect as each section deserves a separate review of its own. However, it highlights all the key points, covered under several facets which can be used by researchers and policymakers to understand the current limitations and the steps that need to be taken to improve health accessibility.
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Affiliation(s)
- Nagesh Shukla
- Centre for Advanced Modelling and Geospatial Information Systems (CAMGIS), University of Technology Sydney, 2007 NSW, Australia; (N.S.); (A.D.); (S.C.)
| | - Biswajeet Pradhan
- Centre for Advanced Modelling and Geospatial Information Systems (CAMGIS), University of Technology Sydney, 2007 NSW, Australia; (N.S.); (A.D.); (S.C.)
- Department of Energy and Mineral Resources Engineering, Sejong University, Choongmu-gwan, 209 Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Abhirup Dikshit
- Centre for Advanced Modelling and Geospatial Information Systems (CAMGIS), University of Technology Sydney, 2007 NSW, Australia; (N.S.); (A.D.); (S.C.)
| | - Subrata Chakraborty
- Centre for Advanced Modelling and Geospatial Information Systems (CAMGIS), University of Technology Sydney, 2007 NSW, Australia; (N.S.); (A.D.); (S.C.)
| | - Abdullah M. Alamri
- Department of Geology & Geophysics, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia;
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