Journal articles on the topic 'Community health services for children Australia'
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1
Townsend, Michelle. "Educational outcomes of children on guardianship or custody orders: A pilot study: Australian Institute of Health and Welfare." Children Australia 32, no. 3 (2007): 4–5. http://dx.doi.org/10.1017/s1035077200011603.
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The Australian Institute of Health and Welfare (AIHW) has recently released a report on the educational outcomes for children and young people on guardianship or custody orders. This report, four years in the making, represents one of the first comprehensive Australian assessments based on educational performance data from multiple jurisdictions for children on guardianship or custody orders. Developed for the National Child Protection and Support Services data group, the study was funded by the Community and Disability Services Ministers’ Advisory Council (AIHW 2007).This pilot study examines how children on guardianship/custody orders are performing compared with all Australian children in education department-based testing for reading and numeracy in years 3, 5 and 7. Mean test scores were examined in addition to the achievement of national benchmarks for reading and numeracy. These nationally agreed benchmarks are designed to assess whether children have achieved the minimum standards for years 3, 5 and 7 (AIHW 2007). Data on 895 children on guardianship or custody orders were collected from five jurisdictions - Queensland, Victoria, South Australia, Tasmania and the Australian Capital Territory - for August 2003 (AIHW 2007). The data were linked through collaborative efforts by state and territory education and community services departments.
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Hawke, Melanie, and Joe Byrne. "Community-based Early Childhood Assessment and Intervention in Rural Settings: Transdisciplinary Case Management of Developmental Delay in Children." Australian Journal of Primary Health 6, no. 4 (2000): 130. http://dx.doi.org/10.1071/py00046.
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This paper reports on an assessment of the need for early intervention services for children aged 0-8 years in the Southern Fleurieu sub-region of South Australia and an evaluation of the efficacy of utilising a generic community health service to provide the therapeutic and case management services to appropriately address those needs. Previous studies in regional South Australia estimated the incidence of developmental delay in children to be 5% of the total population aged 0-8 years (Barossa Valley, 1997). This estimate indicated a client group of over 130 in the Southern Fleurieu sub-region. The project team adopted a transdisciplinary model for early identification and intervention, with over half the children on the program aged less than five years, indicating that the program addressed needs of children at an early age. Outcomes have demonstrated the appropriateness of using a transdisciplinary approach in a regional setting and the community health service as the auspice has shown an increase in the capacity for therapists to provide the wide variety of programs that are essential in addressing early childhood delay.
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Ainsworth, Frank, and Patricia Hansen. "When is Enough Enough? The Burgeoning Cost of Child Protection Services." Children Australia 39, no. 2 (May 21, 2014): 93–98. http://dx.doi.org/10.1017/cha.2014.6.
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The Australian Bureau of Statistics estimates that at 31 December 2011 there were 5,098,694 children and young people in Australia under the age of 18 years, while for the period 1 July 2011 to 30 June 2012, the Australian Institute of Health and Welfare's report on child protection indicates that there were 48,420 substantiated cases of child abuse and neglect in Australia. The likelihood is that almost 95 (94.96) per cent of Australian children and young people were not abused or neglected in that period; and this is a cause for national celebration. These figures are good reason to praise the parents and caregivers of the 5,050,274 children who were not abused or neglected. We argue that there is a need for an emphasis in the political debate about child protection that focuses on children who are not abused, in order for the issue of child abuse and neglect to be placed in proper perspective. The lack of perspective in the current dialogue simply results in an unending demand for more resources for detection-focused services. Instead, there has to be increased emphasis on preventative services for vulnerable families who fail to meet community child-rearing standards. These exacting standards of parenting can only be achieved through parent education and the provision of intensive and extensive family support services, combined with sensitive monitoring of at-risk families. Accordingly, this article is written in a dissenting voice.
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Parker, E. J., G. Misan, M. Shearer, L. Richards, A. Russell, H. Mills, and L. M. Jamieson. "Planning, Implementing, and Evaluating a Program to Address the Oral Health Needs of Aboriginal Children in Port Augusta, Australia." International Journal of Pediatrics 2012 (2012): 1–10. http://dx.doi.org/10.1155/2012/496236.
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Aboriginal Australian children experience profound oral health disparities relative to their non-Aboriginal counterparts. In response to community concerns regarding Aboriginal child oral health in the regional town of Port Augusta, South Australia, a child dental health service was established within a Community Controlled Aboriginal Health Service. A partnership approach was employed with the key aims of (1) quantifying rates of dental service utilisation, (2) identifying factors influencing participation, and (3) planning and establishing a program for delivery of Aboriginal children’s dental services that would increase participation and adapt to community needs. In planning the program, levels of participation were quantified and key issues identified through semistructured interviews. After 3.5 years, the participation rate for dental care among the target population increased from 53 to 70 percent. Key areas were identified to encourage further improvements and ensure sustainability in Aboriginal child oral health in this regional location.
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Buchanan, Fiona. "Zero Tolerance in South Australia: A Statewide Community Initiative." Australian Journal of Primary Health 2, no. 1 (1996): 107. http://dx.doi.org/10.1071/py96013.
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The Zero Tolerance Campaign against violence to women and children is a hard hitting, controversial campaign designed to raise public awareness and provoke debate about male abuse of power in the areas of domestic violence, rape and sexual assault, and child sexual abuse. Zero Tolerance is also an example of best practice in cross sectoral co-operation. The campaign comprises a statewide initiative involving the Health Promotion Unit of the South Australian Health Commission, the Domestic Violence Resource Unit, Family and Community Services, community health workers and local community action groups throughout the state. The process of bringing together a wide range of individuals from very different backgrounds and differing perspectives to work collaboratively on a controversial, innovative project led to extensive examination and defining of the issues involved. The planning process included a microcosm of the debate which Zero Tolerance intends to generate in the community. Resolution of the issues raised, employed many of the strategies developed and identified as best practice in the field of primary health care. The paper explores the challenges and rewards in the context of working collaboratively through the planning of a controversial initiative and identifies the merits of a campaign which has built on a diverse range of knowledge. Zero Tolerance, as a campaign, has the scope to be adapted in a variety of culturally and socially diverse initiatives as it becomes identified as an example of international best practice developed to stop violence against women and children.
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Woolfenden, Susan R., Troy Dalkeith, and Teresa Anderson. "The first eighteen months of a paediatric ambulatory and community service." Australian Health Review 29, no. 4 (2005): 429. http://dx.doi.org/10.1071/ah050429.
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Hospital admission is distressing and traumatic for children as they are separated from their families and home. Internationally, and in Australia, alternative models of health care are being developed to meet the needs of children and their families. We describe the first eighteen months of the establishment of a paediatric ambulatory and community service in a district health service in New South Wales. Key outcomes include: increased referral to the service from acute hospital and primary care services; parental satisfaction and saved hospital beddays. Lessons learnt in the setting up of this service include the need for proactive engagement of consumers and stakeholders; clear definition of roles and responsibilities; and measurable and reasonable performance indicators.
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Grace, Rebekah, Jenny Knight, Kelly Baird, Jonathan Ng, Harry Shier, Sarah Wise, Tobia Fattore, et al. "Where are the silences? A scoping review of child participatory research literature in the context of the Australian service system." Children Australia 44, no. 4 (August 22, 2019): 172–86. http://dx.doi.org/10.1017/cha.2019.32.
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AbstractThis paper presents a scoping review of the literature on child participatory research in Australia published in academic journals between 2000 and 2018. The review focused on research designed to engage with children and young people in the development, implementation and evaluation of services. A total of 207 papers were identified and distributed across eight service sectors: child protection and family law, community, disability, education, health, housing and homelessness, juvenile justice and mental health. The papers were reviewed against Shier’s participation matrix, demonstrating that almost all of the identified papers included children only as participants who contributed data to adult researchers. Only a small number of papers involved children and young people in the other phases of research, such as designing research questions, analysis and dissemination. There is a clear interest in the engagement of children and young people in service design and decision-making in Australia. This paper is intended to serve as a catalyst for discussion on where there are gaps and where further Australian research is needed.
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Muthayya, Sumithra, Andrew Brown, Simone Sherriff, Darryl Wright, Tangerene Ingram, and Jacqueline Davison. "Applying Community-Based system Dynamics to Address Food Insecurity in Non-Remote Indigenous Populations in Australia." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 250. http://dx.doi.org/10.1093/cdn/nzaa043_101.
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Abstract Objectives There is a growing crisis of hunger and food inequality among Indigenous people in Australia who are increasingly urbanized. They experience substantially higher rates of food insecurity than the general population which impacts on diet-sensitive chronic disease risk and life expectancy. This project aimed to apply systems tools to identify systemic challenges to achieving food security and possible local actions to address the problem in two large Aboriginal communities. Methods A qualitative system dynamics method used group model building (GMB) in two regional and outer urban communities involving participants from Aboriginal Community Controlled Health Services, food relief charities, council, educational groups and some food industry partners in the two local areas. The GMB enabled the participants to consider all the connections between contributing factors, feedback and reinforcing loops to produce a map of food insecurity linked to the local food system. This project was done in collaboration with the Study of Environment of Aboriginal Resilience and Child Health (SEARCH), Australia's largest cohort study into the health of urban Aboriginal children. Results The GMB workshops resulted in causal loop diagrams that mapped the complexities of the food insecurity challenge. The maps highlighted the impact of low incomes and unemployment that influenced the communities’ ability to budget and afford healthy food, thereby leading to a reliance on convenience food outlets. This, in turn, influenced communities’ healthy food preferences, which negatively impacted on food security. Additionally, community education around healthy food choices, meal planning and financial literacy were factors that also directly impacted food security. A distinct loop reflected that a lack of coordination between agencies was leading to duplication and confusion about available food relief services and the ability to access these services. Conclusions These analyses elicited local understanding of the potential levers within the system to address food insecurity in Indigenous people. They are being used to develop community-level workplans to shift the high prevalence of food insecurity and its longer-term impact on preventable chronic disease. Funding Sources This work was funded by the Australian Prevention Partnership Centre and the Sax Institute, Sydney.
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Heilbrunn-Lang, Adina Y., Lauren M. Carpenter, Seona M. Powell, Susan L. Kearney, Deborah Cole, and Andrea M. de Silva. "Reviewing public policy for promoting population oral health in Victoria, Australia (2007–12)." Australian Health Review 40, no. 1 (2016): 19. http://dx.doi.org/10.1071/ah15013.
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Objective Government policy and planning set the direction for community decisions related to resource allocation, infrastructure, services, programs, workforce and social environments. The aim of the present study was to examine the policy and planning context for oral health promotion in Victoria, Australia, over the period 2007–12. Methods Key Victorian policies and plans related to oral health promotion in place during the 2007–12 planning cycle were identified through online searching, and content analysis was performed. Inclusion of oral health (and oral health-related) promotion initiatives was assessed within the goals, objectives and strategies sections of each plan. Results Six of the 223 public health plans analysed (3%) included oral health ‘goals’ (including one plan representing nine agencies). Oral health was an ‘objective’ in 10 documents. Fifty-six plan objectives, and 70 plan strategies related to oral health or healthy eating for young children. Oral health was included in municipal plans (44%) more frequently than the other plans examined. Conclusion There is a policy opportunity to address oral health at a community level, and to implement population approaches aligned with the Ottawa Charter that address the social determinants of health. What is known about the topic? Poor oral health is a significant global health concern and places a major burden on individuals and the healthcare system, affecting approximately 50% of all children and 75%–95% of adults in Australia. The Ottawa Charter acknowledges the key role of policy in improving the health of a population; however, little is known about the policy emphasis placed on oral health by local government, primary care partnerships and community health agencies in Victoria, Australia. What does this paper add? This is a review of oral health content within local government (municipal) and community health plans in Victoria, Australia. What are the implications for practitioners? The findings identify several opportunities for public health and community health practitioners and policy makers to place greater emphasis on prevention and improvement of the oral health of Victorians through policy development.
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Segal, Leonie, Sophie Guy, and Gareth Furber. "What is the current level of mental health service delivery and expenditure on infants, children, adolescents, and young people in Australia?" Australian & New Zealand Journal of Psychiatry 52, no. 2 (July 14, 2017): 163–72. http://dx.doi.org/10.1177/0004867417717796.
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Objectives: The study aim was to estimate the current level of ambulatory mental health service delivery to young people aged 0–24 years in Australia and associated government expenditure. Recognising the importance of the early years for the development of mental illness and socioeconomic outcomes, we were particularly interested in service access by infants and young children. Methods: We extracted information from government administrative datasets on the number of people who received mental health services, number of services and expenditure through the health sector for 2014–2015. Results are primarily reported by age groups 0–4, 5–11, 12–17 and 18–24 years. Results: Less than 1% of 0- to 4-year-olds received a mental health service in any one service setting, whereas nearly 11% of 18- to 24-year-olds received a mental health service through the Medicare Benefits Schedule Better Access programme alone. Many more services were delivered to 12- to 24-year-olds (>4 million) than to 0- to 11-year-olds (552,000). Medicare Benefits Schedule Better Access delivers services to more children and youth than do state/territory community mental health services, although the latter provide more services per client. In 2013–2014, Australian Government expenditure on ambulatory mental health services for 0- to 24-year-olds was AUD428 million, similar to the AUD491 million spent by state/territory governments. Conclusion: The study provides a benchmark for data-driven service planning to ensure that the mental health needs of infants, children and young people are met. Our results indicate that the youngest age group are underserviced relative to need, even noting infants and children may receive services for behavioural/mental health issues from providers not captured in our study (such as paediatricians). The developmental origins of mental illness underlies the urgency of adequate provision by governments of perinatal, infant and child mental health services to avoid loss of life potential and reduce the pressures on the justice, child protection and welfare systems.
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Burgell, Bob. "A rejoinder: the real story of the H&CS Enterprise Competency Standards." Children Australia 18, no. 3 (1993): 31–34. http://dx.doi.org/10.1017/s1035077200003552.
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The article ‘A Word Salad - Enterprise Based Competencies in Child Protection’, Children Australia 18 (2) 1993 by Dr. Lesley Cooper, examines the Victorian Department of Health and Community Services (H&CS) Skills Enhancement Project (SEP). H&CS plainly rejects the negative criticisms of the skill analysis work which the article espouses.
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Macdonald, Elspeth, Heather Mohay, Debra Sorensen, Neil Alcorn, Brett Mcdermott, and Erica Lee. "Current Delivery of Infantmental Health Services: Are Infant Mental Health Needs Being Met?" Australasian Psychiatry 13, no. 4 (December 2005): 393–98. http://dx.doi.org/10.1080/j.1440-1665.2005.02232.x.
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Objective: To identify services supporting the well-being of infants and their families in an area of South Brisbane, Australia, highlight problems of accessing these services and recommend strategies to make them more readily available. Method: Semistructured interviews were conducted with staff from 18 service providers offering antenatal services, or programmes primarily focused on children under the age of 2 years and/or their families. The interview aimed to identify the precise nature of the services offered, problems encountered in providing those services, perceived gaps in services and potential strategies for improvement. Results: Services were diverse, provided by a range of different professionals, in varying locations (home, community, hospital) and with funding from various sources. The major findings were:(i) the fragmentation of services, lack of communication between them, and lack of continuity in services from one stage of family formation to another; (ii) the shortage of services working with the parents and infant together; and (iii) the difficulty ofproviding services for some at-risk populations. Conclusions: Recommendations included: (i) maintaining a range of different services networked through a centralized resource/referral centre; (ii) expandingjoint mother–infant services and providing training for such services; and (iii) supporting outreach services for difficult to engage populations.
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Sims, Margaret. "Accreditation and Quality Care for Children with Special Needs." Australasian Journal of Early Childhood 20, no. 4 (December 1995): 5–10. http://dx.doi.org/10.1177/183693919502000403.
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Children with special needs are increasingly attending long day care services in Australia. Currently these services are using an accreditation process designed to improve the quality of service delivery to all children and families. Accreditation consists of a set of 52 principles addressing interactions; programming; nutrition, health and safety practices; and centre management and staff development. This paper examines the factors which contribute to quality child care for children with special needs, and relates these factors to principles in the accreditation document. It is argued that while the child care industry has a wonderful opportunity to demonstrate high quality care for children with special needs, the overall impact of the document serves to reinforce existing stereotypes which place children with special needs on the periphery of community and neighbourhood services.
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Hendrickx, David, Ingrid Amgarth-Duff, Asha C Bowen, Jonathan R Carapetis, Robby Chibawe, Margaret Samson, and Roz Walker. "Barriers and Enablers of Health Service Utilisation for Childhood Skin Infections in Remote Aboriginal Communities of Western Australia." International Journal of Environmental Research and Public Health 17, no. 3 (January 28, 2020): 808. http://dx.doi.org/10.3390/ijerph17030808.
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In Australia, children living in remote Aboriginal communities experience high rates of skin infections and associated complications. Prompt presentation to primary care health services is crucial for early diagnosis and treatment. We performed a qualitative study in four remote Aboriginal communities in the Pilbara region of Western Australia to explore factors that affected health service utilisation for childhood skin infections in this setting. The study consisted of semistructured interviews and focus group discussions with parents and carers (n = 16), healthcare practitioners (n = 15) and other community service providers (n = 25). We used Andersen’s health service utilisation model as an analytical framework. Our analysis captured a wide range of barriers that may undermine timely use of health services for childhood skin infections. These included general factors that illustrate the importance of cultural competency amongst healthcare providers, patient-centred care and community engagement. Relating specifically to health service utilisation for childhood skin infections, we identified their apparent normalisation and the common use of painful benzathine penicillin G injections for their treatment as important barriers. Health service utilisation in this setting may be enhanced by improving general awareness of the significance of childhood skin infections, actively engaging parents and carers in consultation and treatment processes and strengthening community involvement in health service activities.
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Flood, Louise, Matthew McConnell, Luda Molchanoff, Zell Dodd, Jana Sisnowski, Melissa Fidock, Tina Miller, Karli Borresen, Hannah Vogt, and Andrew Lane. "Lessons from a community vaccination programme to control a meningococcal disease serogroup W outbreak in remote South Australia, 2017." Western Pacific Surveillance and Response Journal 12, no. 1 (March 31, 2021): 26–31. http://dx.doi.org/10.5365/wpsar.2019.10.2.002.
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Problem: From December 2016 to February 2017, two cases of invasive meningococcal disease and one case of meningococcal conjuctivitis, all serogroup W, occured in Aboriginal children in the Ceduna region of South Australia. The clustering of cases in time and place met the threshold for a community outbreak. Context: The Ceduna region is a remote part of South Australia, with more than 25% of the population identifying as Aboriginal or Torres Strait Islander. Action: As part of the outbreak response, a community-wide meningococcal vaccination programme against serogroups A, C, W and Y was implemented in a collaboration among different agencies of the South Australian Department for Health and Wellbeing, Aboriginals health and community services providers, and other local service providers and government agencies. Outcome: Between March and June 2017, 3383 persons were vaccinated, achieving an estimate coverage of 71-85% of the target population, with 31% (n = 1034) of those vaccinated identifying as Aboriginal or Torres Strait Islander. No local cases of serogroup W occurred during the vaccination programme, but two further cases were notified by the end of 2018. Discussion: The participation of a large number of local and non-health-sector stakeholders in programme planning and implementation, a clear response management structure and high community acceptability were identified as key factors that contributed to the programme achieving high vaccination coverage. The need to develop standard procedures for community-based outbreak response interventions to ease logistical challenges was considered an important lessons learnt.
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Bolsewicz, Katarzyna, Susan Thomas, Donna Moore, Colleen Gately, Andrew Dixon, Paul Cook, and Peter Lewis. "Using the Tailoring Immunization Programmes guide to improve child immunisation in Umina, New South Wales: we could still do better." Australian Journal of Primary Health 26, no. 4 (2020): 325. http://dx.doi.org/10.1071/py19247.
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In the Central Coast Local Health District of New South Wales, Australia, childhood immunisation (CI) rates are around 95%, but pockets of underimmunisation exist. Using the World Health Organization’s Tailoring Immunization Programmes, we identified areas of potential low vaccine coverage using Australian Immunisation Register (AIR) data (2016–18) and investigated factors that influence CI. Individual and group interviews with carers, community members and service providers (n=52 participants) were conducted. Data were analysed thematically and the themes presented to stakeholders for feedback before finalisation. During 2018, Umina had 218 children at least 1 month overdue for at least one vaccination. Five themes emerged: (1) broader socioeconomic factors may apply pressures that influence CI; (2) parents largely supported immunisation and knew of its benefits to their children and the community; (3) immunisation service providers are committed, experienced and collaborate with community partners; (4) there is potential to increase access to free immunisation services in Umina; and (5) AIR data and reminder systems could be better used to inform service delivery and prompt parents before immunisations are due. This study identified opportunities to improve CI coverage in Umina and new information useful in developing a tailored immunisation strategy. Awareness of the pressures socioeconomic factors may have on families could help plan and deliver supportive primary health care that includes equitable access to immunisation.
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Jordan, Julie, Lola Bishop, and Robynne Hunt. "The Family and Baby Program: Becoming More Accountable." Australian Journal of Primary Health 6, no. 4 (2000): 126. http://dx.doi.org/10.1071/py00045.
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The aim of this paper is to discuss briefly Child and Youth Health's (CYH) Family and Baby Program (FAB). CYH is a statewide community health service for young South Australians funded by the State Government. The organisation has a primary health care focus and works in partnership with individuals, families and communities to enhance the health status of children and young people in South Australia, focusing on the promotion of health and the prevention of ill health. CYH has two divisions, the Child and Family Health Service (which offers health services to families of children aged 0 to 12 years) and The Second Story (which serves the health needs of young people aged 12 to 25 years). It also has a Parent Helpline, a statewide telephone information and support service for parents of both children and young people.
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Hameed, Mohajer Abbass. "Challenges and Opportunities for Innovation in Child Abuse and Neglect Research within the Child Welfare System in Australia." Children Australia 43, no. 1 (January 16, 2018): 57–66. http://dx.doi.org/10.1017/cha.2017.49.
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Child abuse and neglect is a preventable public health issue, yet a complex global phenomenon with considerable adverse impacts on children, families, health and social services, as well as the Australian community. Despite the widespread adverse impact of child abuse and neglect, the research in this field within Australian child welfare systems is relatively scarce. What is needed is to understand the various challenges, barriers and limitations that face child abuse and neglect researchers and impede methodologically rigorous research within child welfare systems in Australia. This paper provides a brief overview of the key methodological limitations, barriers and challenges, as well as the strengths of the research methods used in studying child abuse and neglect. This paper also explores the potential gains from adopting a national translational research framework. Innovative translation of research and knowledge into effective care system responses and evidence-based practices for children remains a pressing issue. Further advances in Australian research and the evidence base will require substantial investment in research and evaluation activities, with a new emphasis on translational research and active collaboration between researchers and practitioners. Finally, this paper concludes with key recommendations and directions for future Australian-based research with the ultimate goal of improving practices and policies.
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Parkinson, Debra, Alyssa Duncan, Jaspreet Kaur, Frank Archer, and Caroline Spencer. "Gendered aspects of long-term disaster resilience in Victoria, Australia." January 2022 10.47389/37, no. 37.1 (January 2022): 59–64. http://dx.doi.org/10.47389/37.1.59.
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Research conducted in 2018 documented the disaster experiences of 56 women and men in Australia aged between 18 and 93 years. This paper draws out the gendered factors that affected their resilience, and in so doing, begins to address the dearth of research related to gendered aspects of long-term disaster resilience. It is unique in capturing the voices of survivors who spoke of events 9 years after the 2009 Black Saturday fires and of earlier fires and floods in Victoria more than 50 years ago, including the 1983 Ash Wednesday fires. Over decades, gendered expectations of men and women significantly hindered resilience. Men spoke of the long-term cost to them of demands to ‘be strong’ in the worst of disasters and reasons they were reluctant to seek help afterwards. Women spoke of their contributions holding a lesser value and of discrimination. Discussions of violence against women and children after disaster, and suicide ideation in anticipation of future disasters offered critical insights. Protective factors identified by informants were not wholly intrinsic to their character but were also physical, such as essential resources provided in the immediate aftermath, and psychological and community support offered in the long-term. Factors that helped resilience departed from the ‘masculine’ model of coping post-disaster by moving away from a refusal to admit trauma and suffering, to community-wide resilience bolstered by widespread emotional, social and psychological support. Genuine community planning for disasters before they strike builds trust and offers insights for emergency management planners.
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Gair, Susan, Jennifer Lehmann, and Rachael Sanders. "Editorial." Children Australia 41, no. 4 (November 29, 2016): 245–46. http://dx.doi.org/10.1017/cha.2016.42.
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Welcome to the final edition of Children Australia for 2016. For this edition, I am pleased to be guest co-editor along with regular editors Jennifer Lehmann and Rachael Sanders. Living in rural and remote Australia can bring a high level of satisfaction and many rewards, including a strong caring community, rich, longstanding social relationships, outdoor lifestyle, happy childhood memories and psychological, cultural, spiritual and economic connections to country. Rural living and working can also bring unique challenges including harsh climatic conditions and crises, a tyranny of distance, isolation, family hardships, limited services and infrastructure, reduced education and employment opportunities; and increased risk of mental health issues, family violence and child safety concerns. The demands of providing remote area health, welfare and other professional services include high visibility and trying to ‘fit in’, managing confidentiality, and dual and inter-relationships. These and other geographical and environmental challenges lead to low workforce retention rates that, in turn, leave significant gaps in service provision for children, families and communities, including Aboriginal communities (Jervis-Tracey et al., 2016; Lehmann, 2015; Robinson, Mares, & Arney, 2016).
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Broadley, Karen, and Chris Goddard. "A Public Health Approach to Child Protection: Why Data Matter." Children Australia 40, no. 1 (November 3, 2014): 69–77. http://dx.doi.org/10.1017/cha.2014.37.
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In Australia, many researchers and policy makers believe that statutory child protection systems are overburdened and ineffective. The way forward, they suggest, is a public health model of child protection. A public health approach comprises four steps: (1) collecting surveillance data; (2) establishing causes and correlations; (3) developing and evaluating interventions; and (4) disseminating information about the effectiveness of intervention activities to the public health community. However, in Australia there are no reliable surveillance data. There is no information about ‘person’. Information is not collected about the characteristics of children (e.g., ethnicity) and parents (e.g., mental illness) reported to child protection services. Data are not comparable across place. This is because the states and territories have their own child protection legislation, definitions and data recording methods. Data are not comparable over time. This is because many jurisdictions have introduced new data recording systems over recent years. This paper concludes that it is essential to develop an effective child protection surveillance data system. This will ensure that services are located in areas and targeted towards populations in greatest need. It will enable large-scale evaluation of the effectiveness of prevention and intervention activities.
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Western, Sally. "Preventing Childhood Injury: Developing a Home Safety Display in a Community Health Centre." Australian Journal of Primary Health 5, no. 1 (1999): 76. http://dx.doi.org/10.1071/py99009.
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Childhood injury is a major health issue, with approximately 20,000 children under five hospitalised each year in Australia. The home is a common site for childhood injuries, with some of the more frequent episodes including falls, poisoning, burns, cuts and crush injuries. A regional initiative to develop a coordinated approach towards minimising injuries sustained by children between 0-4 years, resulted in the development of 'Childsafe Now', a health promotion program which involved training of child care providers, and the establishment of several home safety displays in the Eastern metropolitan region of Victoria. One of the home safety displays was developed in a Community Health Centre, utilising a pre-existing child care facility and the multidisciplinary skills of the staff. Community Health Centres were established with a focus on health promotion - encouraging illness and injury prevention through a holistic combination of education, community involvement, behavioural and social modification and multi-disciplinary primary health care services - yet the opportunity to establish a permanent, functional display which combines all of these aspects of health promotion is becoming increasingly rare. However, the skills and knowledge which have traditionally been nurtured within the Community Health Program make Community Health Centres a particularly appropriate location for establishing a Home Safety Display.
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Barth, Dylan D., Marianne J. Mullane, Claudia Sampson, Coco Chou, Janessa Pickering, Mark P. Nicol, Mark R. Davies, Jonathan Carapetis, and Asha C. Bowen. "Missing Piece Study protocol: prospective surveillance to determine the epidemiology of group A streptococcal pharyngitis and impetigo in remote Western Australia." BMJ Open 12, no. 4 (April 2022): e057296. http://dx.doi.org/10.1136/bmjopen-2021-057296.
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IntroductionGroup A β-haemolytic Streptococcus (GAS), a Gram-positive bacterium, causes skin, mucosal and systemic infections. Repeated GAS infections can lead to autoimmune diseases acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Aboriginal and Torres Strait Islander peoples in Australia have the highest rates of ARF and RHD in the world. Despite this, the contemporaneous prevalence and incidence of GAS pharyngitis and impetigo in remote Australia remains unknown. To address this, we have designed a prospective surveillance study of GAS pharyngitis and impetigo to collect coincident contemporary evidence to inform and enhance primary prevention strategies for ARF.Methods and analysisThe Missing Piece Study aims to document the epidemiology of GAS pharyngitis and impetigo through collection of clinical, serological, microbiological and bacterial genomic data among remote-living Australian children. The study comprises two components: (1) screening of all children at school for GAS pharyngitis and impetigo up to three times a year and (2) weekly active surveillance visits to detect new cases of pharyngitis and impetigo. Environmental swabbing in remote schools will be included, to inform environmental health interventions. In addition, the application of new diagnostic technologies, microbiome analysis and bacterial genomic evaluations will enhance primary prevention strategies, having direct bearing on clinical care, vaccine development and surveillance for vaccine clinical trials.Ethics and disseminationEthical approval has been obtained from the Western Australian Aboriginal Health Ethics Committee (Ref: 892) and Human Research Ethics Committee of the University of Western Australia (Ref: RA/4/20/5101). Study findings will be shared with community members, teachers and children at participating schools, together with academic and medical services. Sharing findings in an appropriate manner is important and will be done in a suitable way which includes plain language summaries and presentations. Finally, findings and updates will also be disseminated to collaborators, researchers and health planners through peer-reviewed journal publications.
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Williamson, Anna, Adam Skinner, Kathleen Falster, Kathleen Clapham, Sandra J. Eades, and Emily Banks. "Mental health-related emergency department presentations and hospital admissions in a cohort of urban Aboriginal children and adolescents in New South Wales, Australia: findings from SEARCH." BMJ Open 8, no. 11 (November 2018): e023544. http://dx.doi.org/10.1136/bmjopen-2018-023544.
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ObjectivesThe aim of the current study is to quantify mental health-related emergency department (ED) presentations and hospitalisations, and associated child and family characteristics, in children recruited through four Aboriginal Community Controlled Health Organisations.SettingFour Aboriginal Community Controlled Health Services that deliver primary care. All services were located in urban or large regional centres in New South Wales, Australia.Participants1476 Aboriginal children aged 0–17 years at recruitment to the Study of Environment on Aboriginal Resilience and Child Health.Primary outcome measuresED presentations and hospital admissions with a primary mental health diagnosis obtained via linkage to population health datasets.ResultsOver a median of 6-year follow-up, there were 96 ED presentations affecting 62 children (10.7/1000 person-years) and 49 hospitalisations affecting 34 children (5.5/1000 person-years) for mental health conditions. Presentations/admissions increased with age. ED presentation was increased with: living in foster versus parental care (adjusted rate ratio (RR)=3.97, 95% CrI 1.26 to 11.80); high versus low baseline child emotional/behavioural problems (adjusted RR=2.93, 95% CrI 1.50 to 6.10); and caregiver chronic health conditions versus none (adjusted RR=2.81, 95% CrI 1.31 to 6.63). Hospitalisations were significantly increased with caregiver unemployment versus home duties (adjusted RR=4.48, 95% CrI 1.26 to 17.94) and caregiver chronic health problems versus none (adjusted RR=3.83, 95% CrI 1.33 to 12.12).ConclusionsTertiary care for mental health issues was relatively common among participating Aboriginal children, with risk elevated for those living in foster care, with prior mental health and behavioural problems and with carers with chronic illness and/or unemployment. While this study suggests high rates of serious mental health events among children from participating communities, the optimum means for reducing these rates, and the need for tertiary care, has not yet been determined. Such information is urgently required to inform policy and programmes to support Aboriginal child and adolescent mental health.
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Hamilton, Sharynne, Deborah Cleland, and Valerie Braithwaite. "‘Why can’t we help protect children too?’ Stigma by association among community workers in child protection and its consequences." Community Development Journal 55, no. 3 (March 6, 2019): 452–72. http://dx.doi.org/10.1093/cdj/bsz004.
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Abstract Community workers provide critical support services to parents and families with children who may be placed in out-of-home care by child protection authorities. Drawing on in-depth interviews with fifteen community workers, who represent nine agencies assisting families with child protection issues in a small jurisdiction in Australia, we show how the stigma attached to ‘bad’ parents is passed on to the community workers who are supporting them. The ‘stigma by association’ directed at community workers by child protection authorities means they are stereotyped negatively, undermined professionally and socially excluded. In spite of such stigmatic treatment, community workers remained committed to their professional role. Although workers were frustrated and disappointed in the treatment they received, there was no open acknowledgment of stigma-induced poor mental health. The results are interpreted within a broader social context where child protection authorities are being constantly reviewed and criticized in Australia. The support that community workers give to each other as frontline defenders of families against a powerful and publicly criticized government authority may allow community workers to construe themselves as heroes rather than villains in this highly adversarial environment. The costs play out at the institutional level, however, because reduced trust limits opportunities for genuine collaboration between government and community organizations.
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Nolan, Andrea, Jennifer Cartmel, and Kym Macfarlane. "Thinking about Practice in Integrated Children's Services: Considering Transdisciplinarity." Children Australia 37, no. 3 (August 9, 2012): 94–99. http://dx.doi.org/10.1017/cha.2012.27.
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Integrated service delivery in the early childhood education and care sector is burgeoning as a direct result of government agendas in Australia that privilege services for young children and families, especially those considered most vulnerable and at risk. In many cases this means reviewing and revising current practice to work more collaboratively with other professionals. This paper reports the findings of one aspect of a larger Australian study entitled: ‘Developing and sustaining pedagogical leadership in early childhood education and care professionals’. The focus of this paper is the understandings and practices of professionals in both Queensland and Victoria working in integrated Children's Services across the education, care, community and health sectors. The notion of transdisciplinary practice is also explored as a way to sustain practice. Qualitative data collection methods, including the ‘Circles of Change’ process, the ‘Significant Change’ method and semi-structured interviews were used. The findings indicate concerns around professional identity, feeling valued, role confusion and the boundaries imposed by funding regulations. Working in a transdisciplinary way was generally considered a useful way to move practice forward in these settings, although the ramifications for leadership that this approach brings requires further consideration.
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Price, Anna M. H., Anna Zhu, Huu N. J. Nguyen, Diana Contreras-Suárez, Natalie Schreurs, Jade Burley, Kenny D. Lawson, et al. "Study protocol for the Healthier Wealthier Families (HWF) pilot randomised controlled trial: testing the feasibility of delivering financial counselling to families with young children who are identified as experiencing financial hardship by community-based nurses." BMJ Open 11, no. 5 (May 2021): e044488. http://dx.doi.org/10.1136/bmjopen-2020-044488.
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IntroductionPoverty and deprivation can harm children’s future health, learning, economic productivity and societal participation. The Australian Healthier Wealthier Families project seeks to reduce the childhood inequities caused by poverty and deprivation by creating a systematic referral pathway between two free, community-based services: universal, well-child nursing services, which provide health and development support to families with children from birth to school entry, and financial counselling. By adapting the successful Scottish ‘Healthier Wealthier Children’ model, the objectives of this Australian pilot are to test the (1) feasibility of systematising the referral pathway, and (2) short-term impacts on household finances, caregiver health, parenting efficacy and financial service use.Methods and analysisThis pilot randomised controlled trial will run in three sites across two Australian states (Victoria and New South Wales), recruiting a total of 180 participants. Nurses identify eligible caregivers with a 6-item, study-designed screening survey for financial hardship. Caregivers who report one or more risk factors and consent are randomised. The intervention is financial counselling. The comparator is usual care plus information from a government money advice website. Feasibility will be evaluated using the number/proportion of caregivers who complete screening, consent and research measures, and access financial counselling. Though powered to assess feasibility, impacts will be measured 6 months post-enrolment with qualitative interviews and questionnaires about caregiver-reported income, loans and costs (adapted from national surveys, for example, the Household, Income and Labour Dynamics in Australia Survey); health (General Health Questionnaire 1, EuroQol five-dimensional questionnaire, Depression, Anxiety, Stress Scale short-form); efficacy (from the Longitudinal Study of Australian Children); and financial service use (study-designed) compared between arms.Ethics and disseminationEthics committees of the Royal Children’s Hospital (HREC/57372/RCHM-2019) and South West Sydney Local Health District (2019/ETH13455) have approved the study. Participants and stakeholders will receive results through regular communication channels comprising meetings, presentations and publications.Trial registration numberACTRN12620000154909; prospectively registered. Pre-results.
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Hammersley, Megan L., Joanne Hedges, Brianna F. Poirier, Lisa M. Jamieson, and Lisa G. Smithers. "Strategies to Support Sustained Participant Engagement in an Oral Health Promotion Study for Indigenous Children and Their Families in Australia." International Journal of Environmental Research and Public Health 19, no. 13 (July 1, 2022): 8112. http://dx.doi.org/10.3390/ijerph19138112.
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The health inequities of Indigenous peoples compared with non-Indigenous peoples are significant and long-standing across many countries. Colonisation and dispossession of land and culture has led to profound and devastating consequences on the health of Indigenous peoples. A lack of trust and cultural security of health services remains a barrier to participation in health care services. Similarly, engagement in research activities is also hindered by a history of unethical research practices. Creating partnerships between researchers and Indigenous communities is key in developing research studies that are culturally appropriate, acceptable and relevant to the needs of Indigenous peoples. Baby Teeth Talk was a randomised controlled trial conducted with Indigenous children and their mothers in South Australia that tested an intervention involving dental care, anticipatory guidance on oral health and dietary intake, and motivational interviewing. The study was developed in consultation and partnership with local Indigenous communities in South Australia and overseen by the study’s Aboriginal reference group. The recruitment and retention of participants in the study has been strong over numerous waves of follow-up. The purpose of this paper is to describe the strategies employed in the study that contributed to the successful and sustained engagement of the participants. These strategies included the establishment of an Aboriginal reference group, building relationships with organisations and community, flexibility of appointment scheduling and allocating adequate time, reimbursement for participant time, developing rapport with participants, encouraging participant self-determination, and adaptation of dietary data collection to better suit participants.
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Mwanri, Lillian, Nelsensius Klau Fauk, Anna Ziersch, Hailay Abrha Gesesew, Gregorius Abanit Asa, and Paul Russell Ward. "Post-Migration Stressors and Mental Health for African Migrants in South Australia: A Qualitative Study." International Journal of Environmental Research and Public Health 19, no. 13 (June 28, 2022): 7914. http://dx.doi.org/10.3390/ijerph19137914.
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We conducted a qualitative study involving African migrants (n = 20) and service providers (n = 10) in South Australia to explore mental health stressors, access to mental health services and how to improve mental health services for African migrant populations. This paper presents the views and experiences of African migrants about the post-migration stressors they faced in resettlement that pose mental health challenges. The participants were recruited using the snowball sampling technique. To align with the COVID-19 pandemic protocol, the data collection was conducted using one-on-one online interviews through Zoom or WhatsApp video calls. Data analysis was guided by the framework analysis. The post-migration stressors, including separation from family members and significant others, especially spouses, imposed significant difficulties on care provision and in managing children’s attitudes and behavior-related troubles at school. African cultural practices involving the community, especially elders in care provision and disciplining children, were not consistent with Australian norms, compounding the mental health stressors for all involved. The African cultural norms, that do not allow young unmarried people to live together, also contributed to child–parent conflicts, enhancing parental mental stressors. Additionally, poor economic conditions and employment-related difficulties were post-migration stressors that the participants faced. The findings indicate the need for policy and intervention programs that address the above challenges. The provision of interventions, including social support such as subsidized or free childcare services, could help leverage their time and scheduled paid employment, creating time for effective parenting and improving their mental health and wellbeing. Future studies exploring what needs to be achieved by government and non-governmental institutions to support enhanced access to social and employment opportunities for the African migrant population are also recommended.
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Jones, Catherine, Jennifer Fraser, and Sue Randall. "An evaluation of training to prepare nurses in a home-based service to care for children and families." Journal of Child Health Care 24, no. 4 (October 15, 2019): 589–602. http://dx.doi.org/10.1177/1367493519881572.
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Evaluation of training was conducted for a paediatric hospital-in-the-home service in Sydney, Australia. Community nurses with no paediatric training or experience were employed and undertook a training program. The aim was to assess the degree to which the training had prepared them to care for children and families in their homes. A mixed-methods design was employed. Overall, the following aspects of the training were well received by the community nurses: paediatric resuscitation, growth and development, clinical deterioration and child protection. Each topic provided basic knowledge and skills in the speciality. The participating nurses generally reached a ‘competent’ level of practice as defined by Benner (2000). Further training and development is recommended. Where paediatric nursing practice is isolated from acute paediatrics services, opportunities must be provided to improve safe levels of practice for children of all ages.
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Hearn, Lydia, Margaret Miller, and Donna Cross. "Engaging Primary Health Care Providers in the Promotion of Healthy Weight among Young Children: Barriers and Enablers for Policy and Management." Australian Journal of Primary Health 13, no. 2 (2007): 66. http://dx.doi.org/10.1071/py07025.
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Recent national efforts to stem the alarming growth of childhood overweight and obesity in Australia have highlighted the importance of preventative strategies that focus beyond the child-on parents, families, primary health care providers (PHCPs) and child care services. But, while such efforts have to date focused on school-based interventions, once poor eating habits and sedentary lifestyles have set in, a growing body of research is indicating that PHCPs can play a more influential role in monitoring and modifying factors affecting prevention and early intervention in preschool children. This paper presents the findings of a systematic review to: (a) identify key barriers to the effective engagement of PHCPs with parents and child care staff in the promotion of healthy weight among children aged 2-6 years, (b) appraise "promising" interventions for strengthening the capacity of PHCPs to effectively deal with these barriers, and (c) synthesise policy options to encourage and engage PHCPs. The study draws on the lessons of promising interventions to highlight the urgent need to address organisational, attitudinal, knowledge, skills and training barriers, to facilitate the engagement of PHCPs in different settings-based environments (clinical, child care, home and community).
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Abdullahi, Ifrah, Estie Kruger, and Marc Tennant. "Service access and perceptions for Somali Australian migrants at risk of autism." International Journal of Migration, Health and Social Care 13, no. 1 (March 6, 2017): 119–25. http://dx.doi.org/10.1108/ijmhsc-09-2015-0031.
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Purpose The purpose of this paper is to examine the service accessibility of Somali Australians suffering Autism Spectrum Disorder (ASD) by using both quantitative and qualitative methods. Design/methodology/approach Using Geographic Information System (GIS) and the 2011 census data a total of 19,178 people reporting Somali ancestry were mapped to SA1 level with most being in the three capital cities of original migration; Sydney, Melbourne and Perth. Findings Access to primary services pertinent to ASD was measured using the GIS software, some 15 per cent of these cities Somali children were within 500 m of a General practice and 89 per cent within 2,000 m. A quarter of children were within 2,000 m of a speech pathology service access point and nearly a third (31 per cent) within 2,000 m of a psychologist. Qualitative analysis found a quite negative perspective on mental illness and ASD within the community with 85 per cent of respondents reporting a “Bad” perception of ASD within the community. Research limitations/implications Clearly, the opportunity these data provide is to develop service models targeting need and changing perspectives of ASD within an at risk community. Originality/value This is the first time in Australia that issues of service access (health) for Autism suffers and their families has been analysed in a detailed geographic manner.
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McNamara, Bridgette, Lina Gubhaju, Louisa Jorm, David Preen, Jocelyn Jones, Grace Joshy, Carrington Shepherd, Daniel McAullay, and Sandra Eades. "Exploring factors impacting early childhood health among Aboriginal and Torres Strait Islander families and communities: protocol for a population-based cohort study using data linkage (the ‘Defying the Odds’ study)." BMJ Open 8, no. 3 (March 2018): e021236. http://dx.doi.org/10.1136/bmjopen-2017-021236.
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IntroductionEmpirical evidence on family and community risk and protective factors influencing the comparatively high rates of potentially preventable hospitalisations and deaths among Aboriginal and Torres Strait Islander infants and children is limited. As is evidence on geographical variation in these risks. The ‘Defying the Odds’ study aims to explore the impact of perinatal outcomes, maternal social and health outcomes and level of culturally secure service availability on the health outcomes of Western Australian (WA) Aboriginal infants and children aged 0–5 years.Methods and analysisThe study combines a retrospective cohort study that uses state-wide linked health and administrative data from 12 data sources for multiple generations within Aboriginal families in WA, with specifically collected survey data from health and social services supporting Aboriginal families in regions of WA. Data sources include perinatal/birth registration, hospital, emergency department, mental health services, drug and alcohol service use, mortality, infectious disease notifications, and child protection and family services. Multilevel regression models will be used to examine the intensity of admissions and presentations, mortality, intensity of long stays and morbidity-free survival (no admissions) for Aboriginal children born in WA in 2000–2013. Relationships between maternal (and grand-maternal) health and social factors and child health outcomes will be quantified. Community-level variation in outcomes for Aboriginal children and factors contributing to this variation will be examined, including the availability of culturally secure services. Online surveys were sent to staff members at relevant services to explore the scope, reach and cultural security of services available to support Aboriginal families across selected regions of WA.Ethics and disseminationEthics approvals have been granted for the study. Interpretation and dissemination are guided by the study team’s Aboriginal leadership and reference groups. Dissemination will be through direct feedback and reports to health services in the study and via scientific publications and policy recommendations.
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Banwell, Cathy, Tambri Housen, Kayla Smurthwaite, Susan Trevenar, Liz Walker, Katherine Todd, May Rosas, and Martyn Kirk. "Health and social concerns about living in three communities affected by per- and polyfluoroalkyl substances (PFAS): A qualitative study in Australia." PLOS ONE 16, no. 1 (January 14, 2021): e0245141. http://dx.doi.org/10.1371/journal.pone.0245141.
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Background Exposure to per- and polyfluoroalkyl substances (PFAS) is a public health issue globally. In Australia high concentrations of PFAS have been found in environments close to sites where Aqueous Film Forming Foams (AFFF) were historically used for firefighting activities. This has resulted in significant community concern about the potential long-term health effects of these chemicals. Objective We describe residents’ perceptions and experiences of PFAS in three regional Australian towns where exposure has occurred. Methods We conducted focus groups to generate free-flowing open discussion on PFAS in three affected communities, including some with significant numbers of First Nations Peoples. We recruited participants using a range of media outlets and postal services. Focus group transcripts were analysed thematically to identify major shared concerns using Atlas Ti. Results One hundred and eighty residents attended fifteen focus groups that were conducted in the three communities. They included 69 First Nations People living in three communities near the town of Katherine in the Northern Territory. Study participants were concerned about potential physical health effects of exposure to PFAS, such as cancer clusters, unexplained deaths, potential exacerbation of existing health conditions, and the future health of their children. They expressed feelings of stress and anxiety about living with uncertainty related to the possible health and the socio-economic impacts of PFAS contamination in their communities. Conclusion While research has concentrated on the physical health effects of PFAS, more attention needs to be given to the immediate psychosocial impacts of living in an affected community.
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Couzos, S., T. Lea, R. Mueller, R. Murray, and M. Culbong. "<p>Effectiveness of ototopical antibiotics for chronic suppurative otitis media in Aboriginal children: a community-based, multicentre, double-blind randomised controlled trial</p>." Community Ear and Hearing Health 4, no. 6 (December 1, 2007): 7. http://dx.doi.org/10.56920/cehh.159.
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Objectives: To compare the effectiveness of ototopical ciprofloxacin (0.3%; CIP) with framycctin (0.5%), gramicidin, dexamethasone (FGD) eardrops (5 drops twice daily for 9 days), together with povidone-iodine (0.5%) ear cleaning, as treatments for chronic suppurative otitis media (CSOM) in Aboriginal children.
Design and Participants: Aboriginal community-controlled, community-based, multicentre, double-blind, randomised controlled trial in eight Aboriginal Community Controlled Health Services across northern Australia, involving 147 Aboriginal children with CSOM.
Main Outcome Measures: Resolution of otorrhoea (clinical cure), proportion of children with healed perforated tympanic membrane (TM) and improved hearing, 10-21 days after starting treatment.
Results: 111 children aged 1-14 years (CIP, 55; FGD, 56) completed treatment. CSOM cures occurred in 64% (CIP, 76.4%; FGD, 51.8%), with a significantly higher rate in the ciprofloxacin group (P = 0.009, absolute difference of 24.6% [95% CI, 15.8%-33.4%]). TM perforation size and the level of hearing impairment did not change. Pseudomonas aeruginosa was the most common bacterial pathogen (in 47.6%), while respiratory pathogens were rare (in 5.7%).
Conclusions: Twice-daily ear cleaning and topical ciprofloxacin are effective at community-level in achieving cure for CSOM. Healthcare providers to Aboriginal children with CSOM should be given special access to provide ototopical ciprofloxacin as first-line treatment.
Published courtesy of:Med J Aust. 2003; 179(4):185-190
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Hoy, Wendy E., Susan Anne Mott, and Beverly June McLeod. "Transformation of mortality in a remote Australian Aboriginal community: a retrospective observational study." BMJ Open 7, no. 8 (August 2017): e016094. http://dx.doi.org/10.1136/bmjopen-2017-016094.
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ObjectivesTo describe trends in ages and causes of death in a remote-living Australian Aboriginal group over a recent 50-year period.DesignA retrospective observational study, from 1960 to 2010, of deaths and people starting dialysis, using data from local clinic, parish, dialysis and birthweight registers.SettingA remote island community in the Top End of Australia’s Northern Territory, where a Catholic mission was established in 1911. The estimated Aboriginal population was about 800 in 1960 and 2260 in 2011.ParticipantsAll Aboriginal residents of this community whose deaths had been recorded.Outcome measuresAnnual frequencies and rates of terminal events (deaths and dialysis starts) by age group and cause of death.ResultsAgainst a background of high rates of low birth weight, 223 deaths in infants and children and 934 deaths in adults (age>15 years) were recorded; 88% were of natural causes. Most deaths in the 1960s were in infants and children. However, over time these fell dramatically, across the birthweight spectrum, while adult deaths progressively increased. The leading causes of adult natural deaths were chronic lung disease, cardiovascular disease and, more recently, renal failure, and rates were increased twofold in those of low birth weight. However, rates of natural adult deaths have been falling briskly since 1986, most markedly among people of age ≥45 years. The population is increasing and its age structure is maturing.ConclusionsThe changes in death profiles, the expression of the Barker hypothesis and the ongoing increases in adult life expectancy reflect epidemiological and health transitions of astonishing rapidity. These probably flow from advances in public health policy and healthcare delivery, as well as improved inter-sectoral services, which are all to be celebrated. Other remote communities in Australia are experiencing the same phenomena, and similar events are well advanced in many developing countries.
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Doyle, June, and Eli Ristevski. "Less germs, less mucus, less snot: teachers' and health workers' perceptions of the benefits and barriers of ear health programs in lower primary school classes." Australian Journal of Primary Health 16, no. 4 (2010): 352. http://dx.doi.org/10.1071/py10024.
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This study explored health and education professionals’ perceptions of the health benefits and barriers of different ear health programs used in lower primary school classes in two district education areas in the Goldfields South East Health Region, Western Australia. Health and education staff providing services to children in kindergarten to year three primary school classes were sent a questionnaire about ear health programs provided in their school. Sixty-one questionnaires were returned from 43 teachers, 14 community health nurses, three Aboriginal health workers and one teacher’s assistant. Some schools implemented all the ear health programs examined at all year levels while others implemented only one of the programs. Teachers, community health nurses and Aboriginal health workers identified that all ear health programs were beneficial to students. Reported physical health benefits included reduced ear infections, early detection of ear infections and improved hearing. Behavioural benefits included improved concentration, alertness and attention in the classroom. Barriers to implementing the programs were obtaining consent from parents/carers, student transience and attendance, time to implement and conduct the programs and human and physical resources. Evaluation methods used varied from no evaluation for the Breathe Blow Cough and tissue spearing programs to limited data collection for audiometry, otoscopy and ear toilet programs. Respondents perceived that ear health programs were effective in improving health and behavioural outcomes for children. A formal pre-post evaluation to provide objective data to confirm this is needed to inform policy around this important health issue.
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Church, Rick. "Case Notes Accreditation: Substitute Care Programmes for Children. A Step Forward." Children Australia 12, no. 4 (1987): 17–18. http://dx.doi.org/10.1017/s0312897000001636.
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A history of children's welfare services in Australia demonstrates the significant and on-going role of the non-government sector. This is particularly true within New South Wales. Many programmes, frequently under the auspice of mainstream religious institutions, were established early in response to critical social needs. These programmes routinely developed in isolation from each other, often with primary ties only to the auspice body and the local community. Some things are slow to change.Today the non-government sector is an amorphous collective of agencies with highly variable philosophical under pinnings, welfare ideologies, resources and competency levels.We have learned a great deal about the needs of children, the process of change, and competency in service delivery (within a specific statutory umbrella). Our new knowledge is yet to be consistently reflected in practice.
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Noon, Ted, and Gary Zadkovich. "Incorporating a health team as part of a disadvantaged high school’s interconnected community learning model." Australian Journal of Primary Health 27, no. 2 (2021): 83. http://dx.doi.org/10.1071/py20168.
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Child poverty rates in Australia remain consistently high, with one in six children living in poverty. High levels of disadvantage result in compounding effects over the life trajectory and include adverse adult health vocational outcomes, increased premature morbidity and mortality and an intergenerational effect. Access to and the availability of services, including health, are restricted due to a complex mix of reasons that include a disconnection between an enabling strategic intent and action. Many young people begin life (including prenatal) with undiagnosed or poorly managed health issues, which subsequently affect the full range of developmental milestones throughout their school years. To counter these gaps in young people’s educational outcomes, a disadvantaged public high school in south-west Sydney introduced, over 10 years, a seven-member school health team employed directly by the school as part of an interconnected model of learning. The focus of this study was to determine the view of staff about the effectiveness and impact of the team as it connects to this holistic model of learning. The comments by staff are very positive and the universal view is that the introduction of a comprehensive interconnected school health team to the high school setting is proving highly beneficial.
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Sarpy, Caroline, Heidi Shukralla, Heath Greville, and Sandra C. Thompson. "Exploring the Implementation of Workplace-Focused Primary Prevention Efforts to Reduce Family Violence in a Regional City: The Need for Clarity, Capacity, and Communication." International Journal of Environmental Research and Public Health 19, no. 24 (December 13, 2022): 16703. http://dx.doi.org/10.3390/ijerph192416703.
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In response to the high burden of family and domestic violence (FDV), The Australian National Plan to End Violence Against Women and Children has established that primary prevention measures are necessary to reduce FDV’s harmful impacts on health. The Community, Respect, and Equality (CRE) project is a primary prevention initiative aimed towards changing harmful social norms and practices that enable FDV in Geraldton, Western Australia. Organizations affiliated with the CRE are required to promote gender equality and a respectful work environment. However, there is a gap in the literature regarding the impact and effectiveness of such interventions, especially in rural/regional areas. As such, this study served to evaluate the project’s effectiveness in a CRE-certified workspace, a local non-profit social services provider. Investigators conducted interviews to learn how the organization had implemented the CRE, and whether the CRE had had an impact on social norms and practices within the work environment. Findings indicated that the project had largely failed to permeate workplace culture due to a lack of effective promotion, low perceived benefits, and low resources. Future interventions must take persuasive measures, even for organizations perceived to be receptive to change.
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Sueur, Eddie Le. "Children's Rights and the State in Loco Parentis." Children Australia 15, no. 2 (1990): 24–28. http://dx.doi.org/10.1017/s1035077200002716.
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The state government Department for Family and Community Services (formerly DCW) in South Australia is currently seeking to clarify and where necessary change policy in the area of guardianship, long term legal status and related issues. To facilitate this aim in the context of a broader consultation process, a discussion paper was prepared by the author in his role of Chief Policy Officer of DCW in October 1989. The full paper covers a range of issues bearing on the department's role in relation to children and their families where there is a possibility of state care being ordered.
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Grace, Rebekah, Kelly Baird, Emma Elcombe, Vana Webster, Jacqueline Barnes, and Lynn Kemp. "Effectiveness of the Volunteer Family Connect Program in Reducing Isolation of Vulnerable Families and Supporting Their Parenting: Randomized Controlled Trial With Intention-To-Treat Analysis of Primary Outcome Variables." JMIR Pediatrics and Parenting 2, no. 2 (November 21, 2019): e13023. http://dx.doi.org/10.2196/13023.
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Background Volunteer home visiting is a widely adopted community-based approach to support families by linking isolated or vulnerable families with community volunteers who visit their homes weekly over approximately 12 months. This study seeks to robustly evaluate the effectiveness of this model of support for families with young children. Objective This paper reports the intention-to-treat analysis of primary and secondary outcomes for a pragmatic randomized controlled trial (RCT) of the Volunteer Family Connect intervention, a volunteer home-visiting program designed to support families with young children who experience social isolation or a lack of parenting confidence and skills. Methods The RCT was conducted across seven sites in Australia. Overall, 341 families were recruited: 169 intervention (services as usual+volunteer home visits) and 172 control (services as usual) families. Intervention families received the program for 3-12 months. Participants were invited to complete six data collection points over a 15-month period. Primary outcomes were community connectedness and parenting competence. Secondary outcomes included parent physical and mental health, general parent wellbeing, parent empowerment, the sustainability of family routines, and the parent-child relationship. According to the protocol, the program would be judged to be effective if at least one of the primary outcomes was significantly positive and the other was neutral (ie, intervention families did not demonstrate positive or negative outcomes compared to the control group). Results The intervention group demonstrated significant improvement in the primary outcome variable parenting sense of competence as compared to the control group. Overall, there was no significant difference between the intervention and control groups with regard to the primary outcome variable community connectedness, other than on the “Guidance” subscale of the Social Provisions Scale. Because there were statistically significant findings for the total score of one primary outcome variable “parenting sense of competence” and largely neutral findings for the primary outcome variable “community connectedness,” the program met the previously defined criteria for program effectiveness. In relation to secondary outcomes, intervention families reported significantly higher wellbeing and were significantly more likely to feel that life was improving. Conclusions The Volunteer Family Connect intervention was considered an effective intervention, with a role to play on the landscape of services available to support vulnerable families with young children. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12616000396426; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370304
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Mendes, Philip. "Remembering the ‘forgotten’ Australians: The Care Leavers of Australia Network and the Senate Inquiry into Institutional and Out-of-home Care." Children Australia 30, no. 1 (2005): 4–10. http://dx.doi.org/10.1017/s103507720001052x.
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This study examines the findings of the recent Community Affairs Reference Committee report into institutional and out-of-home care. Attention is drawn to the key role played by the Care Leavers of Australia Network (CLAN) in pushing the concerns of older care leavers onto the public agenda, successfully lobbying for the Senate Inquiry, and providing services and supports to care leavers.The report highlighted the historical failure of state authorities to protect the well-being of children and young people placed in alternative care. Many of those children have subsequently experienced significant emotional and psychological problems, the results of which include psychiatric illness, depression, suicide, substance abuse, illiteracy, impaired relationship skills and marriage breakdown, and incarceration.The report also has contemporary implications. In order to achieve better outcomes for care leavers in the future, we need to ensure that child welfare services are adequately funded, employ properly trained and qualified professional staff, promote a gradual and functional transition from dependence to independence, and ensure accountability to external bodies including consumer groups.
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Roper, Lucinda, Vincent Yaofeng He, Oscar Perez-Concha, and Steven Guthridge. "Complex early childhood experiences: Characteristics of Northern Territory children across health, education and child protection data." PLOS ONE 18, no. 1 (January 19, 2023): e0280648. http://dx.doi.org/10.1371/journal.pone.0280648.
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Early identification of vulnerable children to protect them from harm and support them in achieving their long-term potential is a community priority. This is particularly important in the Northern Territory (NT) of Australia, where Aboriginal children are about 40% of all children, and for whom the trauma and disadvantage experienced by Aboriginal Australians has ongoing intergenerational impacts. Given that shared social determinants influence child outcomes across the domains of health, education and welfare, there is growing interest in collaborative interventions that simultaneously respond to outcomes in all domains. There is increasing recognition that many children receive services from multiple NT government agencies, however there is limited understanding of the pattern and scale of overlap of these services. In this paper, NT health, education, child protection and perinatal datasets have been linked for the first time. The records of 8,267 children born in the NT in 2006–2009 were analysed using a person-centred analytic approach. Unsupervised machine learning techniques were used to discover clusters of NT children who experience different patterns of risk. Modelling revealed four or five distinct clusters including a cluster of children who are predominantly ill and experience some neglect, a cluster who predominantly experience abuse and a cluster who predominantly experience neglect. These three, high risk clusters all have low school attendance and together comprise 10–15% of the population. There is a large group of thriving children, with low health needs, high school attendance and low CPS contact. Finally, an unexpected cluster is a modestly sized group of non-attendees, mostly Aboriginal children, who have low school attendance but are otherwise thriving. The high risk groups experience vulnerability in all three domains of health, education and child protection, supporting the need for a flexible, rather than strictly differentiated response. Interagency cooperation would be valuable to provide a suitably collective and coordinated response for the most vulnerable children.
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Hnatiuk, Jill A., Genevieve Dwyer, Emma S. George, and Andrew Bennie. "Co-participation in physical activity: perspectives from Australian parents of pre-schoolers." Health Promotion International 35, no. 6 (March 19, 2020): 1474–83. http://dx.doi.org/10.1093/heapro/daaa022.
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Abstract Co-participation in physical activity may be important for helping families with young children meet physical activity recommendations. Yet, little is known about what families perceive to be the benefits, barriers and facilitators of co-participation. This study explored (i) parents’ perceptions about physical activity and possible benefits of family-based co-participation in physical activity, (ii) their perceived facilitators and barriers to co-participation and (iii) their recommendations for improving co-participation within their community. Fifteen parents (14 mothers, 1 father) of 2- to 4-year-old children residing in Western Sydney, Australia, participated in one-on-one interviews between September 2016 and January 2017. Interviews were audio-recorded and transcribed verbatim. Four main themes and seven sub-themes emerged from the thematic analysis of the interview data. When parents were asked to reflect on their understanding of physical activity, they discussed a range of well-known activities (e.g. active play, active transport) and also reported ‘anything but screen time’. The major benefits parents reported about co-participation were spending quality time together, improving children’s general health and well-being and the development of physical skills. Social (e.g. social networks, negative stereotypes) and environmental (e.g. home space, neighbourhood design, shading) facilitators and barriers were identified, yet their impact on co-participation often varied depending on the presence (or lack thereof) of other factors in the physical or social environment. Key recommendations suggested by parents included improvements to home outdoor spaces, neighbourhood design and play spaces and community services.
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Andersson, Ellaina, Cari McIlduff, Karen Turner, Sue Thomas, Jadnah Davies, Elizabeth J. Elliott, and Stewart Einfeld. "Jandu Yani U ‘For All Families’ Triple P—positive parenting program in remote Australian Aboriginal communities: a study protocol for a community intervention trial." BMJ Open 9, no. 10 (October 2019): e032559. http://dx.doi.org/10.1136/bmjopen-2019-032559.
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IntroductionThe population-based (Lililwan) study of fetal alcohol spectrum disorder (FASD) revealed a high prevalence of FASD in the remote communities of the Fitzroy Valley, Western Australia (WA) and confirmed anecdotal reports from families and teachers that challenging child behaviours were a significant concern. In response, Marninwarntikura Women’s Resource Centre initiated a partnership with researchers from The University of Sydney to bring the positive parenting program (Triple P) to the Valley. Triple P has been effective in increasing parenting skills and confidence, and improving child behaviour in various Indigenous communities.Methods and analysisExtensive consultation with community leaders, service providers, Aboriginal health networks and academic institutions was undertaken and is ongoing. Based on community consultations, the intervention was adapted to acknowledge local cultural, social and language complexities. Carers of children born after 1 January 2002 and living in the Fitzroy Valley are invited to participate in Group Triple P, including additional Stepping Stones strategies for children with complex needs. Programme are delivered by local community service workers, trained and accredited as Triple P providers or ‘parent coaches’. Assessments for parent coach pretraining and post-training includes their perceived ability to deliver the intervention and the cultural appropriateness of the programme. Carers complete preintervention and postintervention and 6-month follow-up assessments of parenting practices, self-efficacy and child behaviour.Ethics and disseminationApproval was granted by the University of Sydney Human Ethics Committee, WA Aboriginal Health Ethics Committee, WA Country Health Services Ethics Committee and Kimberley Aboriginal Health Planning Forum. Consultation with community is imperative for efficacy, engagement, community ownership and sustainability of the programme, and will be ongoing until findings are disseminated. Anonymous findings will be disseminated through peer-reviewed journals, community feedback sessions and scientific forums.
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Davies, Jenny, Moira O’Connor, Georgia K. B. Halkett, Lauren Kelada, and Nicholas G. Gottardo. "Parents’ Experiences of Childhood Cancer During the COVID-19 Pandemic: An Australian Perspective." Journal of Pediatric Psychology 47, no. 2 (December 3, 2021): 148–57. http://dx.doi.org/10.1093/jpepsy/jsab125.
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Abstract Introduction COVID-19 has had far-reaching impacts including changes in work, travel, social structures, education, and healthcare. Objective This study aimed to explore the experiences of parents of children receiving treatment for cancer during the COVID-19 pandemic. Methods Parents whose children were currently in treatment for childhood cancer or had completed treatment in the previous 12 months, participated in semi-structured interviews, face-to-face or via teleconferencing. Thematic analysis was used to analyze the data. Results The sample consisted of 34 participants (17 fathers and 17 mothers) from all states across Australia. Median age 37.5 years (range 29–51, years, SD = 6.3). Five main themes were identified: “Welcome to the Club”; “Remote Work and Study”; “Silver Linings”; “The Loneliest Experience” with three sub-themes “Immediate Family”; “Friends”; and “Overseas Family” and “Lack of Support” with two sub-themes: “Community Support” and “Organized Support.” Conclusion These findings revealed contrasting experiences of the impact of the COVID-19 pandemic. For parents whose children were neutropenic, the pandemic provided benefits in increased community understanding of infection control. Parents also reflected that the movement to remote work made it easier to earn an income. In contrast, some parents observed that restrictions on visitors and family intensified feelings of isolation. Parents also described how the COVID-19 reduced access to support services. These findings contribute to an understanding of the multifaceted impacts of the COVID-19 pandemic on families of children with cancer.
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Stubbs, Joanne M., and Helen M. Achat. "Health home visiting for vulnerable families: what has occurred and what is yet to arrive?" Australian Journal of Primary Health 18, no. 1 (2012): 23. http://dx.doi.org/10.1071/py11035.
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Sustained health home visiting (SHHV) is a valuable means of implementing early intervention for vulnerable families with infants or young children. This first of a two-part report describes clients and identifies nurses’ activities with or on behalf of clients as part of a pilot SHHV program undertaken within a socioeconomically disadvantaged suburban area of Sydney, New South Wales, Australia. A forthcoming report describes the results of the intervention. Child and family health nurses visited vulnerable clients who were pregnant and/or had an infant aged 36 months or younger. Interventions consisted of direct and indirect (i.e. services involving a third party) client contact. Nurses documented all activities undertaken with or on behalf of clients using pre-determined codes. Over 29 months, the program accepted 136 referrals and 118 (87%) consented to the evaluation. Families had a mean of eight risk factors, which commonly included current mental health symptoms or disorders (49%), a history or current experience of domestic violence (51%) and being known to the Department of Community Services (40%). Nurses’ most frequent interventions addressed the main carer’s emotional and health needs, and infant development. Clients’ level of need required coordinated care from a specialised multidisciplinary team, which was unavailable to program clients and their families.
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Aston, Jeff, Chi Huynh, Anthony Sinclair, Keith Wilson, and David Terry. "MEDICATION REVIEW OF CHILDREN ON LONG TERM MEDICATIONS: A REVIEW OF THE LITERATURE." Archives of Disease in Childhood 101, no. 9 (August 17, 2016): e2.42-e2. http://dx.doi.org/10.1136/archdischild-2016-311535.47.
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IntroductionChildren on long term medication may be under the care of more than one medical team including the patients GP. Children on chronic medication should be supported and their medications reviewed, especially in cases of polypharmacy. Medicines Use Reviews (MURs) were introduced into the pharmacy contract in 2005. The service was designed for community pharmacists to review patients on long term medication. The service specified that MURs were done on patients who can give consent and cannot be conducted with a parent or carer. Hence the service may be inaccessible to paediatric patients. This review aims to find studies that identify medication review services in primary care that cater for children on long term medication.MethodsA literature search was conducted on 6th June 2015 using the keywords, (“Medication” or “review” or “Medication Review” or “Medicines use review” or “Medication use review” or “New Medicine Service”) AND (“community pharmacy” OR “community pharmacist” OR “primary care” OR “General practice” OR “GP” OR “community paediatrician” OR “community pediatrician” OR “community nurse”). Bibliographic databases used were AMED, British Nursing Index, CINAHL, EMBASE, HMIC, MEDLINE, PsycINFO and Health Business Elite. Inclusion criteria were: paediatric specific medication review in primary care, for example by either a GP, community paediatrician, community nurse or community pharmacist. Exclusion criteria were studies of medication review in adults/unclear patient age and secondary care medication reviews.ResultsFrom the 417 articles, 6 relevant articles were found after abstract and full text review. 235 articles were excluded after title and abstract review (11 did not have full text in English); 96 were adult or non-age specified medication review/MUR/New Medicine Service studies; 63 referred to observational, evaluative studies of interventions in adults; 6 were non-paediatric specific systematic reviews and 17 were protocols, commentaries, news, and letters.The 6 relevant articles consisted of 1 literature review (published 2004), 3 research articles and 1 published protocol. The literature review[1] recommended that children's long term medication should be reviewed. The published protocol stated that the NMS minimum age for inclusion in the trial was for children aged over 13 years of age. The four studies were related to psychiatrists reviewing paediatric mental health patients in the USA, a pharmacist using Drug Related Problem to review patients in GP practices in Australia, a UK study based on an information prescription concept by providing children dispensed medications in community pharmacy with signposting them to health information and one GP practice based study observing pharmaceutical care issues in children and adults.ConclusionThe results show that there are currently no known studies on medication use reviews specific to children, whereas in adults, published evaluations are available. The terms of the MUR policy restrict children's access to the service and so more studies are necessary to determine whether children could benefit from such access.
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Elliott, Galen, Anthony C. Smith, Mark E. Bensink, Cecil Brown, Christine Stewart, Chris Perry, and Paul Scuffham. "The Feasibility of a Community-Based Mobile Telehealth Screening Service for Aboriginal and Torres Strait Islander Children in Australia." Telemedicine and e-Health 16, no. 9 (November 2010): 950–56. http://dx.doi.org/10.1089/tmj.2010.0045.
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