1
|
Wheaton N, Alston E, Versace VL, Field M, Wong Shee A, Jacobs J, Backholer K, Allender S, Nichols M, Needham C, Bolton KA, Blake MR, Stewart F, Close E, Alston L. Diet-Related Disease Prevention in a Rural Australian Setting: Understanding Barriers, Enablers, and the Role of Rural Health Services in Supporting Changes in Local Rural Food Environments. Nutrients 2023; 15:4979. [PMID: 38068837 PMCID: PMC10708407 DOI: 10.3390/nu15234979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
Bold and comprehensive action is needed to prevent diet-related diseases in rural areas, which includes improving food environments to enable healthier dietary practices. Rural health services are integral to the health of rural populations, yet their role in community disease prevention is not swell understood. This study sought to understand health service, local government, and food outlet stakeholders' perspectives on (1) the drivers of unhealthy retail environments in a rural setting; (2) the role of rural health services in supporting changes in local food environments; and to (3) identify characteristics of potential interventions. Two Group Model Building workshops were held with health service and local government leaders (n = 9), and interviews were conducted with local food outlet participants (n = 13). Key themes included 'enablers to healthier food environments', 'barriers to healthier food environments', 'Rural health services are a leading broker of knowledge for healthy food environments', and 'characteristics of desirable healthy food environment interventions.'. Rural health services can play a key role in addressing the current barriers to healthy food environments in rural areas. Effective promotion of healthier diets in rural populations will require consideration of key stakeholder perspectives and the development of further evidence on the role that rural health services can play in improving the healthiness of food environments.
Collapse
Affiliation(s)
- Nikita Wheaton
- Deakin Rural Health, School of Medicine, Deakin University, Warnambool, VIC 3284, Australia; (V.L.V.); (M.F.); (A.W.S.); (L.A.)
| | - Emily Alston
- Research Unit, Colac Area Health, Colac, VIC 3250, Australia; (E.A.); (F.S.); (E.C.)
| | - Vincent L. Versace
- Deakin Rural Health, School of Medicine, Deakin University, Warnambool, VIC 3284, Australia; (V.L.V.); (M.F.); (A.W.S.); (L.A.)
| | - Michael Field
- Deakin Rural Health, School of Medicine, Deakin University, Warnambool, VIC 3284, Australia; (V.L.V.); (M.F.); (A.W.S.); (L.A.)
- Research Unit, Colac Area Health, Colac, VIC 3250, Australia; (E.A.); (F.S.); (E.C.)
| | - Anna Wong Shee
- Deakin Rural Health, School of Medicine, Deakin University, Warnambool, VIC 3284, Australia; (V.L.V.); (M.F.); (A.W.S.); (L.A.)
- Grampians Health, Ballarat, VIC 3350, Australia
| | - Jane Jacobs
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (J.J.); (K.B.); (S.A.); (M.N.); (C.N.); (K.A.B.); (M.R.B.)
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (J.J.); (K.B.); (S.A.); (M.N.); (C.N.); (K.A.B.); (M.R.B.)
| | - Steven Allender
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (J.J.); (K.B.); (S.A.); (M.N.); (C.N.); (K.A.B.); (M.R.B.)
| | - Melanie Nichols
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (J.J.); (K.B.); (S.A.); (M.N.); (C.N.); (K.A.B.); (M.R.B.)
| | - Cindy Needham
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (J.J.); (K.B.); (S.A.); (M.N.); (C.N.); (K.A.B.); (M.R.B.)
| | - Kristy A. Bolton
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (J.J.); (K.B.); (S.A.); (M.N.); (C.N.); (K.A.B.); (M.R.B.)
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3220, Australia
| | - Miranda R. Blake
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia; (J.J.); (K.B.); (S.A.); (M.N.); (C.N.); (K.A.B.); (M.R.B.)
| | - Fletcher Stewart
- Research Unit, Colac Area Health, Colac, VIC 3250, Australia; (E.A.); (F.S.); (E.C.)
| | - Evelyn Close
- Research Unit, Colac Area Health, Colac, VIC 3250, Australia; (E.A.); (F.S.); (E.C.)
| | - Laura Alston
- Deakin Rural Health, School of Medicine, Deakin University, Warnambool, VIC 3284, Australia; (V.L.V.); (M.F.); (A.W.S.); (L.A.)
- Research Unit, Colac Area Health, Colac, VIC 3250, Australia; (E.A.); (F.S.); (E.C.)
| |
Collapse
|
2
|
Needham C, Wheaton N, Wong Shee A, McNamara K, Malakellis M, Murray M, Alston L, Peeters A, Ugalde A, Huggins C, Yoong S, Allender S. Enhancing healthcare at home for older people in rural and regional Australia: A protocol for co-creation to design and implement system change. PLoS One 2023; 18:e0290386. [PMID: 37682945 PMCID: PMC10490867 DOI: 10.1371/journal.pone.0290386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/07/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND World-wide, health service providers are moving towards innovative models of clinical home-based care services as a key strategy to improve equity of access and quality of care. To optimise existing and new clinical home-based care programs, evidence informed approaches are needed that consider the complexity of the health care system across different contexts. METHODS We present a protocol for working with health services and their partners to perform rapid identification, prioritisation, and co-design of content-appropriate strategies to optimise the delivery of healthcare at home for older people in rural and regional areas. The protocol combines Systems Thinking and Implementation Science using a Consensus Mapping and Co-design (CMC) process delivered over five workshops. DISCUSSION The protocol will be implemented with rural and regional healthcare providers to identify digital and non-digital solutions that have the potential to inform models of service delivery, improve patient experience, and optimise health outcomes. The combination of system and implementation science is a unique approach for optimising healthcare at home for older populations, especially in the rural context where need is high. This is the first protocol to integrate the use of systems and implementation science into one process and articulating these methods will help with replicating this in future practice. Results of the design phase will translate into practice through standard health service planning methods to enhance implementation and sustainability. The delivery of the protocol will include building capacity of health service workers to embed the design, implementation, and evaluation approach into normal practice. This protocol forms part of the DELIVER (Delivering Enhanced heaLthcare at home through optImising Virtual tools for oldEr people in Rural and regional Australia) Project. Funded by Australia's Medical Research Future Fund, DELIVER involves a collaboration with public health services of Western Victoria, Australia.
Collapse
Affiliation(s)
- Cindy Needham
- Institute for Health Transformation, Global Centre for Preventative Health and Nutrition, School of Health and Social Development Faculty of Health, Deakin University, Geelong, Australia
| | - Nikita Wheaton
- Institute for Health Transformation, Global Centre for Preventative Health and Nutrition, School of Health and Social Development Faculty of Health, Deakin University, Geelong, Australia
| | - Anna Wong Shee
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
- Community and Aged Care, Grampians Health, Ballarat, Victoria, Australia
| | - Kevin McNamara
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
| | - Mary Malakellis
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
| | - Margaret Murray
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
| | - Laura Alston
- Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
- Research Unit, Colac Area Health, Colac, Victoria, Australia
| | - Anna Peeters
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Anna Ugalde
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Catherine Huggins
- Institute for Health Transformation, Global Centre for Preventative Health and Nutrition, School of Health and Social Development Faculty of Health, Deakin University, Geelong, Australia
| | - Serene Yoong
- Institute for Health Transformation, Global Centre for Preventative Health and Nutrition, School of Health and Social Development Faculty of Health, Deakin University, Geelong, Australia
| | - Steven Allender
- Institute for Health Transformation, Global Centre for Preventative Health and Nutrition, School of Health and Social Development Faculty of Health, Deakin University, Geelong, Australia
| |
Collapse
|
4
|
Abstract
BACKGROUND New mothers often need support to establish and maintain breastfeeding, and rural women may find it difficult to access breastfeeding resources locally. There are many smartphone applications for breastfeeding mothers; however, very few have been developed by health professionals. We evaluated a smartphone application, Breastfeeding Solutions, developed by U.S. IBCLC Nancy Mohrbacher. Research aims: The aims were (a) to explore usability of the application among rural Australian breastfeeding women and (b) to describe participants' infant feeding outcomes compared with the general population. METHODS A prospective longitudinal self-report survey design was used. Data were collected via online questionnaires at baseline and at 3 and 6 months from a convenience sample of new mothers. The setting was southwest Victoria, Australia, from 2016 to 2017. Descriptive statistics were used to answer research aims. RESULTS Of the initial 46 participants who received the app, 63% ( n = 29) completed surveys at 3 and 6 months. Usability was assessed at 3 months: 93.5% of participants (29 of 31) rated the application favorably, whereas 96.8% (30 of 31) found the application helpful and 87.1% (27 of 31) would recommend it to other mothers. At the 6-month survey, 79% of participants ( n = 23) were breastfeeding; 10% ( n = 3) had stopped breastfeeding during the first 3 months. The local breastfeeding rate at 6 months was approximately 50% according to routinely collected data; however, we cannot infer that the application was responsible for the difference. CONCLUSION The smartphone application was acceptable to breastfeeding women in an Australian rural setting. Further evaluation using a user-centered design could improve rural postpartum women's access to reliable, evidence-based information.
Collapse
Affiliation(s)
| | | | - Lisa H Amir
- 3 Judith Lumley Centre, La Trobe University, Melbourne, Australia
| |
Collapse
|
6
|
Abstract
OBJECTIVES To investigate the sociodemographic and behavioural factors associated with incidence, persistence or remission of obesity in a longitudinal sample of Australian children aged 4-10 years. SETTING Nationally representative Longitudinal Study of Australian Children (LSAC). PARTICIPANTS The sample for this analysis included all children in the Kinder cohort (aged 4-5 years at wave 1) who participated in all four waves of LSAC (wave 1, 2004, aged 4-5 years; wave 2, 2006, aged 6-7 years; wave 3, 2008, aged 8-9 years and wave 4, 2010, aged 10-11 years). Of the 4983 children who participated in the baseline (wave 1) survey, 4169 (83.7%) children completed all four waves of data collection. PRIMARY AND SECONDARY OUTCOME MEASURES Movement of children between weight status categories over time and individual-level predictors of weight status change (sociodemographic characteristics, selected dietary and activity behaviours). RESULTS The study found tracking of weight status across this period of childhood. There was an inverse association observed between socioeconomic position and persistence of overweight/obesity. Sugar-sweetened beverages and fruit and vegetable intake and screen time appeared to be important predictors of stronger tracking. CONCLUSIONS Overweight and obesity established early in childhood tracks strongly to the middle childhood years in Australia, particularly among children of lower socioeconomic position and children participating in some unhealthy behaviour patterns.
Collapse
Affiliation(s)
- Nikita Wheaton
- Faculty of Health, WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, Australia
| | - Lynne Millar
- Faculty of Health, WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, Australia
| | - Steven Allender
- Faculty of Health, WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, Australia
| | - Melanie Nichols
- Faculty of Health, WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, Australia
| |
Collapse
|