Journal articles on the topic 'Preventive health services Victoria'
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Martin-Kerry, Jacqueline M., Martin Whelan, John Rogers, Anil Raichur, Deborah Cole, and Andrea M. de Silva. "Addressing disparities in oral disease in Aboriginal people in Victoria: where to focus preventive programs." Australian Journal of Primary Health 25, no. 4 (2019): 317. http://dx.doi.org/10.1071/py18100.
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The aim of this study is to determine where Aboriginal people living in Victoria attend public oral health services; whether they access Aboriginal-specific or mainstream services; and the gap between dental caries (tooth decay) experience in Aboriginal and non-Aboriginal people. Analysis was undertaken on routinely collected clinical data for Aboriginal patients attending Victorian public oral health services and the distribution of Aboriginal population across Victoria. Approximately 27% of Aboriginal people attended public oral health services in Victoria across a 2-year period, with approximately one in five of those accessing care at Aboriginal-specific clinics. In regional Victoria, 6-year-old Aboriginal children had significantly higher levels of dental caries than 6-year-old non-Aboriginal children. There was no significant difference in other age groups. This study is the first to report where Aboriginal people access public oral health care in Victoria and the disparity in disease between Aboriginal and non-Aboriginal users of the Victorian public oral healthcare system. Aboriginal people largely accessed mainstream public oral healthcare clinics highlighting the importance for culturally appropriate services and prevention programs to be provided across the entire public oral healthcare system. The findings will guide development of policy and models of care aimed at improving the oral health of Aboriginal people living in Victoria.
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Anderson, Philip. "Developing Preventive Services." Children Australia 13, no. 2 (1988): 16–19. http://dx.doi.org/10.1017/s0312897000001880.
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Before discussing the types of services that are required I would like to look, just briefly, at some of the recent history in the provision of services.Edith Bennett was the Director of the Family Welfare Division in what is now Community Services Victoria. Those of you who have been around for more than ten years will remember her. She once said that what we need is a range of flexible services. Being rather young and believing I knew it all I thought at the time that this was a load of simplistic rubbish. How could something so simple be true. The field likes to make these things complex. However, looking back I feel she had made a key point that is perfectly obvious now.
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Mitchell, Brian. "Preventative Child Welfare Services in Victoria." Children Australia 13, no. 1 (1988): 10–14. http://dx.doi.org/10.1017/s0312897000001752.
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The idea of prevention in child welfare is not new. The prevention of substitute placement of children whether on a temporary or long-term basis has been a fundamental principle of child welfare we have held to for many years in Victoria.However, it is only in the last decade that this principle is actually being carried out in practice by a number of voluntary agencies. For many children placement is still commonly used as a solution it is easier to place a child than to promote change within many multi-deficit families.
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M. Brown, Rhonda. "Community Health Within the Context of Health Reform." Australian Journal of Primary Health 6, no. 1 (2000): 85. http://dx.doi.org/10.1071/py00009.
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Recent health reforms in Victoria based on a market model characterised by competition and market control of health services, have radically changed the funding and management of community health organisations and the way health services are provided. Community health has sustained ongoing funding cuts, restructures, amalgamations, and corporatisation over the past decade. Within the context of reform community health has been forced to become competitive through improvement in the efficiency and effectiveness of services. At the same time organisations must collaborate to ensure a co-ordinated approach to health care and continue to provide services which are responsive to community needs. With diminishing government funding community health organisations must seek alternative funding sources through the tendering process. A 1998 study of one of the largest metropolitan community health organisations in Victoria gives some insights into the impact of these reforms. The findings of this study show that health reforms based on market principles are not compatible with the delivery of health care, and in particular with primary health care, the underlying philosophy of community health. Organisations are becoming more bureaucratic and hierarchical with decision making being driven by management rather than by consultation with community and staff. Resources are being diverted from health promotion and community development activities to direct services, that are individual and problem focused rather than community and prevention focused.
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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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Galbally, Rhonda. "Mental Health Promotion in Victoria: A Strategic Approach." Australasian Psychiatry 5, no. 1 (February 1997): 14–18. http://dx.doi.org/10.3109/10398569709082086.
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Health promotion has proved to be crucial in most areas of health, for example, cardiovascular health, cancer control and injury prevention. However, mental health promotion has hitherto been a very poor cousin by comparison with funds spent on other health promotion areas, and also by comparison with funds spent on mental health services. This situation is understandable. First, there has been a need to shake mental health services out of antiquity to ensure that they not only meet fundamental standards of human rights, but also begin to develop a focus on rehabilitation. Second, the amorphous, unspecific and often haphazard nature of the few existing mental health promotion programs has, to a degree, given mental health promotion a bad name. As mental health promotion initiatives must inevitably relate to social and structural issues, the health content of mental health promotion has sometimes been hard to identify.
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Klein, Harald. "Reforming Primary Care in Victoria: Will Primary Care Partnerships Do the Job?" Australian Journal of Primary Health 8, no. 1 (2002): 23. http://dx.doi.org/10.1071/py02004.
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Spiralling medical costs and escalating demand for health services are putting primary care reform firmly on the agenda for governments around the world. A more coordinated and prevention-oriented approach must be adopted now to avoid a looming crisis in health care. In Victoria, the Primary Care Partnership (PCP) Strategy aims to improve health outcomes and better manage the demand for services by functionally integrating health and community support services. This paper provides an overview of the key factors that have shaped primary care reform in the State of Victoria; the logic of the PCP Strategy; a summary of the results of the strategy after 18 months; and a critical assessment of the key challenges for the strategy in the future. The paper concludes that the strategy has already led to much stronger collaboration between agencies, more integrated service planning and emerging models for service coordination. For these achievements to translate to improved health outcomes, the systems changes being initiated by PCPs need to be translated into the way services are provided in the community. This cannot be achieved by collaboration between service providers alone. It is now time for all relevant parts of government to support PCP objectives and initiatives in the way they plan and fund services.
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Lin, Clare, Nuno Goncalves, Ben Scully, Ruth Heredia, and Shalika Hegde. "A Teledentistry Pilot Study on Patient-Initiated Care." International Journal of Environmental Research and Public Health 19, no. 15 (July 31, 2022): 9403. http://dx.doi.org/10.3390/ijerph19159403.
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COVID-19 has challenged the public dental workforce in their ability to continue providing routine oral health care services. To mitigate the risk of COVID-19 transmission to staff and patients, Teledentistry was implemented in many parts of the world, mainly to provide remote consultations, undertake triage, and offer preventive educational sessions. The aim of this paper is to describe Dental Health Services Victoria’s (DHSV) patient-initiated Teledentistry model of care implemented during peak COVID transmission in Victoria. The Teledentistry model supported patient-centered care involving active collaboration and shared decision making between patients, families, and clinicians in designing and managing remote care plans. DHSV’s eligible patient cohort includes disadvantaged population groups with greater oral health needs. Strong emphasis was placed on the simplicity and user friendliness of the Telehealth platform, as well as the support for patients with low technology literacy. Consumers and dental workforce were consulted and modifications to the use of language and services were undertaken before the launch. A total of 2492 patients accessed Telehealth services between May 2020 and April 2021. Approximately 39% of patients were born in a country other than Australia. A total of 489 patient-reported experience measures (PREMs) were received. Patients agreed or strongly agreed that the care they received met their needs (87%); they received answers to their questions (89%); they left their visit knowing what is next (87%); they felt they were taken care of during their visit (90%); and they felt involved in their treatment (89%). Teledentistry enabled patients to initiate access to care and consult with dental workforce remotely and safely during peak pandemic.
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Heilbrunn-Lang, Adina Y., Lauren M. Carpenter, Andrea M. de Silva, Lisa K. Meyenn, Gillian Lang, Allison Ridge, Amanda Perry, Deborah Cole, and Shalika Hegde. "Family-centred oral health promotion through Victorian child-health services: a pilot." Health Promotion International 35, no. 2 (April 21, 2019): 279–89. http://dx.doi.org/10.1093/heapro/daz025.
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Abstract Maternal and Child Health Services (MCHS) provide ideal settings for oral disease prevention. In Victoria (Australia), child mouth-checks (Lift-the-Lip) and oral health promotion (OHP) occur during MCHS child visits. This study trialled Tooth-Packs (OHP resources, toothbrushes, toothpastes) distribution within MCHS to (i) assess the impacts of Tooth-Packs distribution on child and family oral health (OH) behaviours and knowledge, including Maternal and Child Health Nurses (MCHN) child referral practices to dental services, and (ii) determine the feasibility and acceptability of incorporating Tooth-Packs distribution into MCHN OHP practices. A mixed-methods evaluation design was employed. MCHN from four high-needs Victorian Local Government Areas distributed Tooth-Packs to families of children attending 18-month and/or 24-month MCHS visits (baseline). Families completed a questionnaire on OH and dietary practices at baseline and 30-month follow-up. Tooth-Packs distribution, Lift-the-lip mouth-checks and child OH referrals were conducted. Guided discussions with MCHN examined intervention feasibility. Overall, 1585 families received Tooth-Packs. Lift-the-lip was conducted on 1493 children (94.1%). Early childhood caries were identified in 142 children (9.5%) and these children were referred to dental services. Baseline to follow-up behavioural improvements (n = 230) included: increased odds of children having ever seen an OH professional (OR 28.0; 95% CI 7.40–236.88; p < 0.001), parent assisted toothbrushing twice/day (OR 1.76; 95% CI 1.05–3.00; p = 0.030) and toothpaste use >once/day (OR 2.82; 95% CI 1.59–5.24; p < 0.001). MCHN recommendations included distribution of Tooth-Packs to at-risk children <12-months of age. MCHS provide an ideal setting to enable timely family-centred OHP intervention and adoption of good OH behaviours at an early age.
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Adams, Karen, Chris Halacas, Marion Cincotta, and Corina Pesich. "Mental health and Victorian Aboriginal people: what can data mining tell us?" Australian Journal of Primary Health 20, no. 4 (2014): 350. http://dx.doi.org/10.1071/py14036.
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Nationally, Aboriginal people experience high levels of psychological distress, primarily due to trauma from colonisation. In Victoria, Aboriginal Community Controlled Health Organisations (ACCHOs) provide many services to support mental health. The aim of the present study was to improve understanding about Victorian Aboriginal people and mental health service patterns. We located four mental health administrative datasets to analyse descriptively, including Practice Health Atlas, Alcohol and Other Drug Treatment Service (AODTS), Kids Helpline and Close The Gap Pharmaceutical Scheme data. A large proportion of the local Aboriginal population (70%) were regular ACCHO clients; of these, 21% had a mental health diagnosis and, of these, 23% had a Medicare Mental Health Care Plan (MHCP). There were higher rates of Medicare MHCP completion rates where general practitioners (GPs) had mental health training and the local Area Mental Health Service had a Koori Mental Health Liaison Officer. There was an over-representation of AODTS episodes, and referrals for these episodes were more likely to come through community, corrections and justice services than for non-Aboriginal people. Aboriginal episodes were less likely to have been referred by a GP or police and less likely to have been referrals to community-based or home-based treatment. There was an over-representation of Victorian Aboriginal calls to Kids Helpline, and these were frequently for suicide and self-harm reasons. We recommend primary care mental health programs include quality audits, GP training, non-pharmaceutical options and partnerships. Access to appropriate AODTS is needed, particularly given links to high incarcerations rates. To ensure access to mental health services, improved understanding of mental health service participation and outcomes, including suicide prevention services for young people, is needed.
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Tabrizi, Sepehr N., Barbara A. Paterson, Christopher K. Fairley, Francis J. Bowden, and Suzanne M. Garland. "Comparison of tampon and urine as self-administered methods of specimen collection in the detection of Chlamydia trachomatis , Neisseria gonorrhoeae and Trichomonas vaginalis in women." International Journal of STD & AIDS 9, no. 6 (June 1, 1998): 347–49. http://dx.doi.org/10.1258/0956462981922386.
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1 Department of Microbiology, The Royal Women's Hospital, Victoria, 2 Menzies School of Health Research, Rocklands Drive, Tiwi, 3 Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Prahran, Victoria and 4 AIDS/STD Unit, Centre for Disease Control, Territory Health Services, Darwin, Australia Summary: Self-administered sampling techniques for the detection of sexually transmitted diseases (STDs) are particularly useful due to their ease of collection and better patient compliance. Urine specimens, and recently tampons, have been described as methods of specimen collection for the detection of some STDs in women. In this study, 660 women had both first-void urine (FVU) and tampon specimens analysed by polymerase chain reaction (PCR) for the detection of Chlamydia trachomatis , Neisseria gonorrhoeae and Trichomonas vaginalis . Overall 6.5%, 10.1% and 17.9% of urine samples were positive whereas 7%, 21.2% and 22% of tampon specimens were positive for C. trachomatis , N. gonorrhoeae and T. vaginalis respectively. Tampon-collected specimens tested by PCR were more sensitive than urine specimens for the detection of N. gonorrhoeae and T. vaginalis ( P 0.001) and equally sensitive for the detection of C. trachomatis ( P =0.45). <
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Bennett, N. J., J. M. Bradford, A. L. Bull, and L. J. Worth. "Infection prevention quality indicators in aged care: ready for a national approach." Australian Health Review 43, no. 4 (2019): 396. http://dx.doi.org/10.1071/ah18052.
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Accreditation standards for Australian aged care homes include the requirement for programs to ensure infections are controlled. Effective infection prevention programs are supported by surveillance data providing the impetus for quality improvement and facilitating evaluation of interventions at the facility level. In 2016, infection control professionals employed in Victorian public-sector residential aged care services were surveyed to examine the nature and resourcing of local infection prevention programs and monitoring activities. Overall, 164 services participated (90% response rate). A high proportion (84%) reported executive support for infection surveillance, with mean allocation of 12h per fortnight per facility for infection prevention activities. Current surveillance activities included monitoring of infections and antimicrobial use (90%), influenza vaccination compliance for staff (96%) and residents (76%) and monitoring of infection due to significant organisms (84%). A successful statewide program including eight quality indicators has subsequently been implemented in Victoria. We suggest that a national focus could strengthen this framework, ensuring a uniform strategy with enhanced benchmarking capacity. Stakeholder engagement and refinement of appropriate indicators for monitoring quality improvement in public, not-for-profit and private sectors within aged care is required.
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Walker, Rae, Sally Mitchell, and Maria Wright. "Inter-Organisational Relationships of Community Health Centres." Australian Journal of Primary Health 3, no. 4 (1997): 18. http://dx.doi.org/10.1071/py97036.
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It is often argued that community based health organisations ought to have substantial links with other organisations in their local environment in order to provide integrated, accountable clinical and preventive services. This paper reports results from a study of the links forged by staff working in four community health centres in Victoria, Australia. The pattern of links between organisations is described and their functions explored. The perceptions of community health workers and their network partners in the other organisations are compared and the strategies used by the workers to establish and build their links identified. It can be argued that links with external organisations are important in community health practice and are valued by the organisations with which the centres establish links. They have, however, received very little attention within or without the field of community health. They are taken for granted, rarely discussed, and as often inhibited as facilitated by the structures within which community health centres operate. Consequently, a great deal of valuable community health work remains unacknowledged, potentially underdeveloped and undervalued. It has not been made clear how education can best support community health staff in this aspect of their work.
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Young, Jesse T., Cheneal Puljević, Alexander D. Love, Emilia K. Janca, Catherine J. Segan, Donita Baird, Rachel Whiffen, Stan Pappos, Emma Bell, and Stuart A. Kinner. "Staying Quit After Release (SQuARe) trial protocol: a randomised controlled trial of a multicomponent intervention to maintain smoking abstinence after release from smoke-free prisons in Victoria, Australia." BMJ Open 9, no. 6 (June 2019): e027307. http://dx.doi.org/10.1136/bmjopen-2018-027307.
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IntroductionSmoke-free policies have been introduced in prisons internationally. However, high rates of relapse to smoking after release from prison indicate that these policies typically result in short-term smoking cessation only. These high rates of relapse, combined with a lack of investment in relapse prevention, highlight a missed opportunity to improve the health of a population who smoke tobacco at two to six times the rate of the general population. This paper describes the rationale and design of a randomised controlled trial, testing the effectiveness of a caseworker-delivered intervention promoting smoking cessation among former smokers released from smoke-free prisons in Victoria, Australia.Methods and analysisThe multicomponent, brief intervention consists of behavioural counselling, provision of nicotine spray and referral to Quitline and primary care to promote use of government-subsidised smoking cessation pharmacotherapy. The intervention is embedded in routine service delivery and is administered at three time points: one prerelease and two postrelease from prison. Control group participants will receive usual care. Smoking abstinence will be assessed at 1 and 3 months postrelease, and confirmed with carbon monoxide breath testing. Linkage of participant records to survey and routinely collected administrative data will provide further information on postrelease use of health services and prescribed medication.Ethics and disseminationEthical approval has been obtained from the Corrections Victoria Research Committee, the Victorian Department of Justice Human Research Ethics Committee, the Department of Human Services External Request Evaluation Committee and the University of Melbourne Human Research Ethics Committee. Results will be submitted to major international health-focused journals. In case of success, findings will assist policymakers to implement urgently needed interventions promoting the maintenance of prison-initiated smoking abstinence after release, to reduce the health disparities experienced by this marginalised population.Trial registration numberACTRN12618000072213; Pre-results.
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Fernando, Dasamal Tharanga, Angela Clapperton, and Janneke Berecki-Gisolf. "Suicide following hospital admission for mental health conditions, physical illness, injury and intentional self-harm in Victoria, Australia." PLOS ONE 17, no. 7 (July 11, 2022): e0271341. http://dx.doi.org/10.1371/journal.pone.0271341.
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Objective The majority of suicide decedents have had contact with health services close to their death. Some of these contacts include admissions to hospitals for physical and mental health conditions, injury and intentional self-harm. This study aims to establish and quantify the risks of suicide following hospital admission for a range of mental and physical illnesses. Methods A retrospective analysis was carried out on existing morbidity and mortality data in Victoria. Data was extracted from the Victorian Admitted Episodes Dataset and the Victorian Suicide Register. Unplanned hospital admissions among adult patients (> = 15 years of age), discharged between 01 January 2011 and 31 December 2016 (2,430,154 admissions), were selected. Standardised Mortality Ratios were calculated for conditions with at least five linked suicides within one year of discharge from hospital. Results Forty-three conditions defined at the three-digit level of the International Statistical Classification of Diseases and Related Health Problems 10th Revision, were associated with at least five subsequent suicides (within one year of hospital discharge); 14 physical illnesses, 5 symptoms, signs and abnormal clinical and laboratory findings, 12 mental health conditions, and 12 types of injury and poisonings. The highest Standardised Mortality Ratios were for poisonings (range; 27.8 to 140.0) and intentional self-harm (78.8), followed by mental health conditions (range; 15.5 to 72.9), symptoms, signs and abnormal clinical and laboratory findings (range; 1.4 to 43.2) and physical illnesses (range; 0.7 to 4.9). Conclusions Hospital admissions related to mental health conditions and injury and poisonings including self-harm were associated with a greater risk of suicide than physical conditions. Mental health conditions such as depressive episodes, personality disorders and psychotic episodes, injuries caused by intentional-self-harm and poisonings by certain types of drugs, carbon monoxide and hormones such as insulin can be prioritised for targeting suicide prevention initiatives for persons discharged from hospitals.
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Shih, S., R. Carter, S. Heward, and C. Sinclair. "Costs Related to Skin Cancer Prevention in Victoria and Australia." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 9s. http://dx.doi.org/10.1200/jgo.18.10800.
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Background: The aim of this presentation is to provide an update on the economic evaluation of the Australian SunSmart program as well as outline the cost of skin cancer treatment to the Victorian public hospital system. This follows the publication of two recently released published economic evaluations that discusses the potential effects of skin cancer prevention inventions. Aim: 1. To highlight the cost effectiveness of skin cancer prevention in Australia 2. To highlight the costs of skin cancer treatment in the Victorian public hospital system 3. To provide strong evidence to inform governments of the value of skin cancer prevention to reduce the costs of treatment in future years. Methods: Program cost was compared with cost savings to determine the investment return of the program. In a separate study, a prevalence-based cost approach was undertaken in public hospitals in Victoria. Costs were estimated for inpatient admissions, using state service statistics, and outpatient services based on attendance at three hospitals in 2012-13. Cost-effectiveness for prevention was estimated from 'observed vs expected' analysis, together with program expenditure data. Results: With additional $AUD 0.16 ($USD 0.12) per capita investment into skin cancer prevention across Australia from 2011 to 2030, an upgraded SunSmart Program would prevent 45,000 melanoma and 95,000 NMSC cases. Potential savings in future healthcare costs were estimated at $200 million, while productivity gains were significant. A future upgraded SunSmart Program was predicted to be cost-saving from the funder perspective, with an investment return of $3.20 for every additional dollar the Australian governments/funding bodies invested into the program. In relation to the costs to the Victorian public hospital system, total annual costs were $48 million to $56 million. Skin cancer treatment in public hospitals ($9.20∼$10.39 per head/year) was 30-times current public funding in skin cancer prevention ($0.37 per head/year). Conclusion: The study demonstrates the strong economic credentials of the SunSmart Program, with a strong economic rationale for increased investment. Increased funding for skin cancer prevention must be kept high on the public health agenda. This would also have the dual benefit of enabling hospitals to redirect resources to nonpreventable conditions.
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Hegarty, Kelsey, Rhian Parker, Danielle Newton, Laura Forrest, Janelle Seymour, and Lena Sanci. "Feasibility and acceptability of nurse-led youth clinics in Australian general practice." Australian Journal of Primary Health 19, no. 2 (2013): 159. http://dx.doi.org/10.1071/py12025.
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Internationally, youth access to primary health care is problematic due to documented barriers such as cost, concerns about confidentiality, and knowledge about when to attend and available services. The treatment of health problems earlier in life together with engagement in prevention and health education can optimise youth health and maximise the potential of future wellbeing. This study investigated the feasibility, acceptability and cost of establishing nurse-led youth clinics in Victoria, Australia. Three general practices in rural and regional areas of Victoria implemented the nurse-led youth health clinics. The clinics were poorly attended by young people. Practice nurses identified several barriers to the clinic attendance including the short timeframe of the study, set times of the clinics and a lack of support for the clinics by some GPs and external youth health clinics, resulting in few referrals. The clinics cost from $5912 to $8557 to establish, which included training the practice nurses. Benefits of the clinics included increased staff knowledge about youth health issues and improved relationships within the general practice staff teams. The implementation of youth health clinics is not feasible in a short timeframe and to maximise use of the clinics, all members of the general practice team need to find the clinics acceptable.
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Beauchamp, Alison, Jason Talevski, Stephen J. Nicholls, Anna Wong Shee, Catherine Martin, William Van Gaal, Ernesto Oqueli, et al. "Health literacy and long-term health outcomes following myocardial infarction: protocol for a multicentre, prospective cohort study (ENHEARTEN study)." BMJ Open 12, no. 5 (May 2022): e060480. http://dx.doi.org/10.1136/bmjopen-2021-060480.
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IntroductionLow health literacy is common in people with cardiovascular disease and may be one factor that affects an individual’s ability to maintain secondary prevention health behaviours following myocardial infarction (MI). However, little is known about the association between health literacy and longer-term health outcomes in people with MI. The ENhancing HEAlth literacy in secondary pRevenTion of cardiac evENts (ENHEARTEN) study aims to examine the relationship between health literacy and a number of health outcomes (including healthcare costs) in a cohort of patients following their first MI. Findings may provide evidence for the significance of health literacy as a predictor of long-term cardiac outcomes.Methods and analysisENHEARTEN is a multicentre, prospective observational study in a convenience sample of adults (aged >18 years) with their first MI. A total of 450 patients will be recruited over 2 years across two metropolitan health services and one rural/regional health service in Victoria, Australia. The primary outcome of this study will be all-cause, unplanned hospital admissions within 6 months of index admission. Secondary outcomes include cardiac-related hospital admissions up to 24 months post-MI, emergency department presentations, health-related quality of life, mortality, cardiac rehabilitation attendance and healthcare costs. Health literacy will be observed as a predictor variable and will be determined using the 12-item version of the European Health Literacy Survey (HLS-Q12).Ethics and disseminationEthics approval for this study has been received from the relevant human research ethics committee (HREC) at each of the participating health services (lead site Monash Health HREC; approval number: RES-21-0000-242A) and Services Australia HREC (reference number: RMS1672). Informed written consent will be sought from all participants. Study results will be published in peer-reviewed journals and collated in reports for participating health services and participants.Trial registration numberACTRN12621001224819.
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Team, Victoria, Ayoub Bouguettaya, Catelyn Richards, Louise Turnour, Angela Jones, Helena Teede, and Carolina D. Weller. "Patient education materials on pressure injury prevention in hospitals and health services in Victoria, Australia: Availability and content analysis." International Wound Journal 17, no. 2 (December 18, 2019): 370–79. http://dx.doi.org/10.1111/iwj.13281.
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Hall, Martin, and Bradley Christian. "A health-promoting community dental service in Melbourne, Victoria, Australia: protocol for the North Richmond model of oral health care." Australian Journal of Primary Health 23, no. 5 (2017): 407. http://dx.doi.org/10.1071/py17007.
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Despite the best efforts and commitment of oral health programs, there is no evidence that the current surgical output-based model of oral health care is delivering better oral health outcomes to the community. In fact, Australian evidence indicates the oral health of the community could be getting worse. It is now well-understood that this traditional surgical model of oral health care will never successfully manage the disease itself. It is proposed that a health-promoting, minimally invasive oral disease management model of care may lead to a sustainable benefit to the oral health status of the individual and community groups. The aim of this paper is to describe such a model of oral health care (MoC) currently being implemented by the North Richmond Community Health Oral Health (NRCH-OH) program in Melbourne, Victoria, Australia; this model may serve as a template for other services to re-orient their healthcare delivery towards health promotion and prevention. The paper describes the guiding principles and theories for the model and also its operational components, which are: pre-engagement while on the waitlist; client engagement at the reception area; the assessment phase; oral health education (high-risk clients only); disease management; and reviews and recall.
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Mendes, Philip. "From minimal intervention to minimal support: Child protection services under the neo-liberal Kennett Government in Victoria 1992-1999." Children Australia 26, no. 1 (2001): 4–11. http://dx.doi.org/10.1017/s103507720001004x.
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This article examines the politics and ideology of Victorian child protection services during the Kennett years. The argument advanced is that the Kennett Liberal/National Party Coalition Government viewed child abuse in narrow, individualistic terms. In contrast to the previous Labor Government, which emphasized a philosophy of minimal intervention based on a partnership of family, community and the state, the Kennett philosophy was one of minimal support. The key emphasis was on the reporting of child abuse to statutory child protection authorities, and the treatment and punishment of individual offenders. Spending on broader structural prevention and support services which actually help the victims of abuse was not a priority.A number of examples of this neo-liberal agenda are given, including the poorly timed introduction of mandatory reporting and the associated diversion of resources from support services to investigation; the early cuts to accommodation and non-government support services; the inadequate response to demonstrated links between child abuse and poverty; the censorship of internal and external critics; and the appalling handling of the strike by child protection workers. Attention is focused primarily on the broader macro-political debates, rather than specific micro-service delivery issues.
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Cyril, Sheila, Michael Polonsky, Julie Green, Kingsley Agho, and Andre Renzaho. "Readiness of communities to engage with childhood obesity prevention initiatives in disadvantaged areas of Victoria, Australia." Australian Health Review 41, no. 3 (2017): 297. http://dx.doi.org/10.1071/ah16069.
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Objective Disadvantaged communities bear a disproportionate burden of childhood obesity and show low participation in childhood obesity prevention initiatives. This study aims to examine the level of readiness of disadvantaged communities to engage with childhood obesity prevention initiatives. Methods Using the community readiness model, 95 semi-structured interviews were conducted among communities in four disadvantaged areas of Victoria, Australia. Community readiness analysis and paired t-tests were performed to assess the readiness levels of disadvantaged communities to engage with childhood obesity prevention initiatives. Results The results showed that disadvantaged communities demonstrated low levels of readiness (readiness score = 4/9, 44%) to engage with the existing childhood obesity prevention initiatives, lacked knowledge of childhood obesity and its prevention, and reported facing challenges in initiating and sustaining participation in obesity prevention initiatives. Conclusion This study highlights the need to improve community readiness by addressing low obesity-related literacy levels among disadvantaged communities and by facilitating the capacity-building of bicultural workers to deliver obesity prevention messages to these communities. Integrating these needs into existing Australian health policy and practice is of paramount importance for reducing obesity-related disparities currently prevailing in Australia. What is known about the topic? Childhood obesity prevalence is plateauing in developed countries including Australia; however, obesity-related inequalities continue to exist in Australia especially among communities living in disadvantaged areas, which experience poor engagement in childhood obesity prevention initiatives. Studies in the USA have found that assessing disadvantaged communities’ readiness to participate in health programs is a critical initial step in reducing the disproportionate obesity burden among these communities. However, no studies in Australia have assessed disadvantaged communities’ readiness to engage in obesity prevention initiatives. What does this paper add? This paper addresses the current gap in the knowledge of disadvantaged communities’ level of readiness to engage in childhood obesity prevention initiatives in Australia. The study also identified the key factors responsible for low readiness of disadvantaged communities to participate in current childhood obesity prevention services. By using the Community Readiness model this study shows the readiness levels specific to the various dimensions of the model; Understanding dimension-specific readiness allows us to identify strategies that are tailored to each dimension, as guided by the model. What are the implications for practitioners? With the increasing burden of childhood obesity on disadvantaged communities, policymakers and health practitioners are facing a crisis in obesity prevention and management. Almost every year, new interventions are being planned and implemented. However if the target communities are not ready to participate in the available interventions these efforts are futile. This study exposes the key factors responsible for low readiness to participate in current obesity prevention services by disadvantaged communities. Addressing these key factors and improving readiness before designing new interventions will improve the participation of disadvantaged communities in those interventions. The study findings ultimately have the potential of reducing obesity-related disparities in Australia.
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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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Mullan, Leanne, Karen Wynter, Andrea Driscoll, and Bodil Rasmussen. "Barriers and enablers to providing preventative and early intervention diabetes-related foot care: a qualitative study of primary care healthcare professionals' perceptions." Australian Journal of Primary Health 27, no. 4 (2021): 319. http://dx.doi.org/10.1071/py20235.
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This study explored the perceived healthcare system and process barriers and enablers experienced by GPs and Credentialled Diabetes Educators (CDEs) in Australian primary care, in the delivery of preventative and early intervention foot care to people with diabetes. A qualitative design with inductive analysis approach was utilised and reported according to the Consolidated Criteria for Reporting Qualitative Studies (COREQ). Semi-structured interviews were conducted with two GPs and 14 CDEs from rural, urban and metropolitan areas of Australia. Participants were from New South Wales, South Australia, Victoria, Western Australia, the Northern Territory and Queensland. Barriers to providing foot care constituted five broad themes: (1) lack of access to footcare specialists and services; (2) education and training insufficiencies; (3) human and physical resource limitations related to funding inadequacies; (4) poor care integration such as inadequate communication and feedback across services and disciplines, and ineffectual multidisciplinary care; and (5) deficient footcare processes and guidelines including ambiguous referral pathways. Enablers to foot care were found at opposing ends of the same spectra as the identified barriers or were related to engaging in mentorship programs and utilising standardised assessment tools. This is the first Australian study to obtain information from GPs and CDEs about the perceived barriers and enablers influencing preventative and early intervention diabetes-related foot care. Findings offer an opportunity for the development and translation of effective intervention strategies across health systems, policy, funding, curriculum and clinical practice, in order to improve outcomes for people with diabetes.
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Pirkis, Jane, Philip Burgess, and Damien Jolley. "Suicide Among Psychiatric Patients: A Case-Control Study." Australian & New Zealand Journal of Psychiatry 36, no. 1 (February 2002): 86–91. http://dx.doi.org/10.1046/j.1440-1614.2002.00993.x.
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Objective: To examine patient- and treatment-based differences between psychiatric patients who do and do not die by suicide. Method: By linking databases of deaths and psychiatric service use in Victoria, we compared 597 cases who suicided over 5 years with individually matched controls. Results: Cases and controls could not be distinguished on the majority of patient- or treatment-based characteristics. The exceptions were that cases were more likely to be male, less likely to be outside the labour force, more likely to have recent contact with inpatient and community services, and more likely to have a registration as their last contact. Conclusions: Patients who suicide ‘look’ similar to those who do not, suggesting prevention approaches should ensure that all psychiatric patients receive optimal care, including appropriate detection, diagnosis, assessment and treatment of mental health problems, and careful, individualised assessment of suicide risk.
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Tumwine, Christopher, Peter Aggleton, and Stephen Bell. "Enhancing HIV Prevention: Social Support, Access to, and Use of HIV Testing, Treatment, and Care Services in Fishing Communities Around Lake Victoria, Uganda." AIDS Education and Prevention 32, no. 3 (June 2020): 196–211. http://dx.doi.org/10.1521/aeap.2020.32.3.196.
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In-depth interviews were conducted with 42 HIV-positive fisherfolk and 15 health care providers to identify experiences of social support and its influence on access to and use of HIV testing, treatment, and care. Fisherfolk participants reported receiving support at some point. Prior to HIV diagnosis, this usually took the form of advice on what illness they were dealing with and remedies to use. After HIV diagnosis and disclosure to friends or family, emotional support enabled fisherfolk to come to terms with an HIV diagnosis, informational support offered guidance on how best to live with HIV, while instrumental support enabled access to relevant HIV services. Finally, affiliative support, in the form of new friends met through HIV clinic visits, provided a sense of belonging. Each of these different kinds of support assisted fisherfolk to respond positively to HIV with important consequences for secondary and tertiary prevention.
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Haukioja, Heather Seija Marguerite. "Exploring the Nature of Elder Abuse in Ethno-Cultural Minority Groups: A community-based participatory research study." Arbutus Review 7, no. 1 (August 8, 2016): 51. http://dx.doi.org/10.18357/tar71201615681.
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<p class="p1">Elder abuse is a significant public health, social justice, and human rights issue in today’s society. Despite the recognition that elder<span class="s1">1 </span>abuse affects older adults across all racial, ethnic, and cultural groups, very little is known about the experiences of elder abuse among people from diverse ethno-cultural backgrounds in Canada. The primary objective of this study is to explore the nature of elder abuse within the two largest ethno-cultural minority groups in British Columbia (BC), the Chinese and South Asians (i.e., those who were either born in or can trace their ancestry to South Asia, which includes nations such as India, Pakistan, Sri Lanka, Bangladesh, and Nepal). Using a community-based participatory research approach,this study is a collaboration between three academics at the University of Victoria and four front-line workers from the Inter-Cultural Association of Greater Victoria (ICA), a not-for-profit, multicultural services organization for immigrants and refugees. The qualitative findings from this interview-based study reveal that cultural context, immigration status, and ethnicity are significant factors influencing experiences of elder abuse. Further, the findings provide insights into what resources — awareness and prevention — need to be developed in order to address the issue of elder abuse in these communities.</p>
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Nguyen, Thi L., Katharine S. Baker, Liane Ioannou, Behrooz Hassani-Mahmooei, Stephen J. Gibson, Alex Collie, Jennie Ponsford, Peter A. Cameron, Belinda J. Gabbe, and Melita J. Giummarra. "Prognostic Role of Demographic, Injury and Claim Factors in Disabling Pain and Mental Health Conditions 12 Months after Compensable Injury." International Journal of Environmental Research and Public Health 17, no. 19 (October 7, 2020): 7320. http://dx.doi.org/10.3390/ijerph17197320.
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Identifying who might develop disabling pain or poor mental health after injury is a high priority so that healthcare providers can provide targeted preventive interventions. This retrospective cohort study aimed to identify predictors of disabling pain or probable mental health conditions at 12 months post-injury. Participants were recruited 12-months after admission to a major trauma service for a compensable transport or workplace injury (n = 157). Injury, compensation claim, health services and medication information were obtained from the Victorian Orthopaedic Trauma Outcome Registry, Victorian State Trauma Registry and Compensation Research Database. Participants completed questionnaires about pain, and mental health (anxiety, depression, posttraumatic stress disorder) at 12 months post-injury. One third had disabling pain, one third had at least one probable mental health condition and more than one in five had both disabling pain and a mental health condition at 12 months post-injury. Multivariable logistic regression found mental health treatment 3–6 months post-injury, persistent work disability and opioid use at 6–12 months predicted disabling pain at 12 months post-injury. The presence of opioid use at 3–6 months, work disability and psychotropic medications at 6–12 months predicted a mental health condition at 12 months post-injury. These factors could be used to identify at risk of developing disabling pain who could benefit from timely interventions to better manage both pain and mental health post-injury. Implications for healthcare and compensation system are discussed.
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Hallinan, Christine M., and Kelsey L. Hegarty. "Advanced training for primary care and general practice nurses: enablers and outcomes of postgraduate education." Australian Journal of Primary Health 22, no. 2 (2016): 113. http://dx.doi.org/10.1071/py14072.
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The aims of the present study were to understand enablers to participation in postgraduate education for primary care nurses (PCNs), and to explore how postgraduate education has advanced their nursing practice. Cross-sectional questionnaires were mailed out in April 2012 to current and past students undertaking postgraduate studies in primary care nursing at The University of Melbourne, Victoria, Australia. Questionnaires were returned by 100 out of 243 nurses (response rate 41%). Ninety-one per cent (91/100) of the respondents were first registered as nurses in Australia. Fifty-seven per cent were hospital trained and 43% were university educated to attain their initial nurse qualification. The respondents reported opportunities to expand scope of practice (99%; 97/98), improve clinical practice (98%; 97/99), increase work satisfaction (93%; 91/98) and increase practice autonomy (92%; 89/97) as factors that most influenced participation in postgraduate education in primary care nursing. Major enablers for postgraduate studies were scholarship access (75%; 71/95) and access to distance education (74%; 72/98). Many respondents reported an increased scope of practice (98%; 95/97) and increased job satisfaction (71%; 70/98) as an education outcome. Only 29% (28/97) cited an increase in pay-rate as an outcome. Of the 73 PCNs currently working in general practice, many anticipated an increase in time spent on the preparation of chronic disease management plans (63%; 45/72), multidisciplinary care plans (56%; 40/72) and adult health checks (56%; 40/72) in the preceding 12 months. Recommendations emerging from findings include: (1) increased access to scholarships for nurses undertaking postgraduate education in primary care nursing is imperative; (2) alternative modes of course delivery need to be embedded in primary care nursing education; (3) the development of Australian primary care policy, including policy on funding models, needs to more accurately reflect the educational level of PCNs, PCN role expansion and the extent of interprofessional collaboration that is evident from research undertaken to date. Nurses with postgraduate education have the potential to increase their scope of practice, take on a greater teaching role and provide more preventive and chronic disease services in primary care. Policies aimed at increasing access to education for nurses working in primary care would strengthen the primary care nursing profession, and enhance the delivery of primary health care services in Australia.
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Kennedy, Alison, Jessie Adams, Jeremy Dwyer, Muhammad Aziz Rahman, and Susan Brumby. "Suicide in Rural Australia: Are Farming-Related Suicides Different?" International Journal of Environmental Research and Public Health 17, no. 6 (March 18, 2020): 2010. http://dx.doi.org/10.3390/ijerph17062010.
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Rural Australians experience a range of health inequities—including higher rates of suicide—when compared to the general population. This retrospective cohort study compares demographic characteristics and suicide death circumstances of farming- and non-farming-related suicides in rural Victoria with the aim of: (a) exploring the contributing factors to farming-related suicide in Australia’s largest agricultural producing state; and (b) examining whether farming-related suicides differ from suicide in rural communities. Farming-related suicide deaths were more likely to: (a) be employed at the time of death (52.6% vs. 37.7%, OR = 1.84, 95% CIs 1.28–2.64); and, (b) have died through use of a firearm (30.1% vs. 8.7%, OR = 4.51, 95% CIs 2.97–6.92). However, farming-related suicides were less likely to (a) have a diagnosed mental illness (36.1% vs. 46.1%, OR=0.66, 95% CIs 0.46–0.96) and, (b) have received mental health support more than six weeks prior to death (39.8% vs. 50.0%, OR = 0.66, 95% CIs 0.46–0.95). A range of suicide prevention strategies need adopting across all segments of the rural population irrespective of farming status. However, data from farming-related suicides highlight the need for targeted firearm-related suicide prevention measures and appropriate, tailored and accessible support services to support health, well-being and safety for members of farming communities.
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MacLachlan, Jennifer H., and Benjamin C. Cowie. "Uptake and trends in ordering of funded hepatitis B immunisation for priority populations in Victoria, Australia, 2013–2014." Sexual Health 14, no. 2 (2017): 188. http://dx.doi.org/10.1071/sh16002.
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Background The Department of Health and Human Services in Victoria provides funded hepatitis B vaccine to many priority groups at risk of acquiring infection. We aimed to determine the uptake of vaccine ordering for at-risk groups over time, to assess any trends and identify any gaps in prevention of hepatitis B for those at risk. Methods: Routinely collected administrative data regarding the indication for vaccine ordered by practitioners were analysed for the period June 2013 to December 2014. Number of doses and courses distributed was determined and compared with the estimated size of the priority populations. Results: During the 18-month period assessed, 20 498 doses of funded hepatitis B vaccine were ordered, equating to ~5700 complete courses, with the overall number of orders per quarter increasing between 2013 and 2014. The most common indication was being a household or sexual contact of people living with hepatitis B (2803 courses, 49.2% of the total), equating to approximately one course per new chronic hepatitis B notification. The remaining doses were largely distributed to people living with HIV (648 courses, 11.4%), people living with hepatitis C (621 courses, 10.9%), and people who inject drugs (594 courses, 10.4%). Conclusions: This analysis demonstrates that access to hepatitis B immunisation among priority populations appears to have increased in Victoria during 2013–14, however it could still be improved. Continued assessment of these data over time will be important to measure the impact of interventions on increasing the reach of the funded vaccine program.
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Paton, Kate, Lynn Gillam, Hayley Warren, Melissa Mulraney, David Coghill, Daryl Efron, Michael Sawyer, and Harriet Hiscock. "How can the education sector support children’s mental health? Views of Australian healthcare clinicians." PLOS ONE 17, no. 1 (January 24, 2022): e0261827. http://dx.doi.org/10.1371/journal.pone.0261827.
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Objectives Policy makers in developed countries have long considered the education system an avenue for supporting mental health care for children. Whilst educators have identified many challenges to providing this support (e.g. non-core role, stigma, overcrowded curriculum), understanding clinicians’ views on the role of educators and schools and how clinicians and schools could work together to achieve good mental health outcomes are important questions. However, clinician voices in how schools and health should work together for children’s mental health care are frequently missing from the debate. We aimed to report clinicians’ views about how the education system could support student’s mental health and improve access to mental health care for children and adolescents. Methods 143 clinicians (approximately 35 each of child and adolescent psychiatrists, pediatricians, child psychologists and general practitioners (GPs)) from the states of Victoria and South Australia participated in semi-structured phone interviews between March 2018 and February 2019. Inductive content analysis was applied to address the broad study aims. Findings Key themes emerged: (1) The role of schools in supporting individual children; (2) School based programs to support children and families; and (3) Challenges of implementing these suggestions. Clinicians across all professional groups suggested the education system could play an important role in improving access to mental health services through harnessing existing staff or co-locating mental health clinicians. They also suggested schools could identify at risk children and implement coping and social skills programs. Conclusions Schools and educators could play a key role in prevention and early intervention of children’s mental health problems. However, before recommending exactly how to do this, key evidence gaps need to be addressed.
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Perrin, Byron M., Marcus J. Gardner, Susan R. Kennett, Jodie L. Cornelius, and Michael J. Fanning. "An organised approach to the podiatric care of people with diabetes in regional Australia." Australian Health Review 36, no. 1 (2012): 16. http://dx.doi.org/10.1071/ah11010.
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Objective. To ensure an efficient publicly funded podiatric service for people with diabetes in regional Victoria, a Podiatry Diabetes Model (PDM) of care was developed. The aim of this study was to determine if people with diabetes attended the most appropriate podiatric service as depicted by the model. Methods. A 3-month prospective clinical audit of the PDM was undertaken. Primary variables of interest were the podiatric service where the patients were seen and the patients’ risk of future foot morbidity. Chi-square analyses for each service category were undertaken to compare the expected number of patients seen according to foot-health risk as predicted by the model, with what was observed. Results. Five hundred and seventy-six people with diabetes were seen in the 3-month period. There was no statistically significant difference between the proportion of patients seen by each podiatric service according to risk status, with what was expected (community: χ2 = 3.3, P = 0.4; subacute: χ2 = 8.0, P = 0.05; acute: χ2 = 6.6, P = 0.09). Conclusions. The Podiatry Diabetes Model is a sound podiatric model of care and is an example of cross-organisational collaboration that could be implemented in other areas of Australia. What is known about the topic? Diabetes-related foot complications are a significant burden on health systems and individuals with diabetes. Podiatric services are important in the prevention and management of complications such as peripheral neuropathy, ulceration and lower limb amputation. It is important to organise healthcare systems to ensure appropriate and efficient services are provided for people with diabetes. What does this paper add? This paper describes and tests a novel collaborative, multi-organisation podiatric model of care for people with diabetes in a large regional Australian setting. What are the implications for practitioners? This paper demonstrates that it is possible to collaborate across multiple organisations to provide a comprehensive publicly funded podiatric service to people with diabetes that encompasses the entire risk spectrum for future diabetes-related foot complications.
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Pereira, Robert B., Timothy L. Brown, Alison Guida, Nerida Hyett, Mary Nolan, Lidia Oppedisano, Kayla Riley, and Grace Walker. "Consumer experiences of care coordination for people living with chronic conditions and other complex needs: an inclusive and co-produced research study." Australian Health Review 45, no. 4 (2021): 472. http://dx.doi.org/10.1071/ah20108.
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ObjectiveThe aim of this study was to explore consumer experiences of care coordination within Barwon Health’s Hospital Admission Risk Program (HARP) located in Geelong, Victoria. MethodsThe study design was qualitative description informed by phenomenology and inclusive and co-production methodology. Semi-structured interviews were conducted with a purposive sample of six consumers living with chronic conditions and other complex needs. Participants were asked about their lived experience related to accessing the service, communication, and health and supports before and after accessing the service using an interview guide. Interviews were audio-recorded and transcribed verbatim for thematic analysis. ResultsFive themes were identified: (1) experiencing authentic, values-based care; (2) collaborative care and working together; (3) gaining independence; (4) improved health and quality of life; and (5) limited understanding of HARP at the start. Overall, participants’ experiences were positive, which related to improved health, quality of life, and sustainable supports. Although gains were experienced, most of the participants identified that their knowledge of HARP was limited when services commenced, which is an area for service improvement. ConclusionThis research begins to address the knowledge gap related to consumer experiences of care coordination. Findings highlight the importance of providing person-centred, authentic and values-based care, listening authentically, and promoting consumer voice within services. The study demonstrates that inclusive, co-design research is feasible in this service context, and further research is recommended into how stakeholders understand the function of care coordination services to promote health and prevent hospital readmissions, and improve consumer participation. What is known about the topic?Care coordination is multifaceted, with the primary purpose of facilitating person-centred care through appropriate and timely delivery of healthcare services. Despite the effectiveness of care coordination programs in preventing avoidable hospital admissions and reducing hospital length of stay, there is a paucity of research that has investigated consumer perspectives. There is also limited research that has adopted an inclusive research design of knowledge co-production where clinicians and consumers are included as equal members of the research team. What does this paper add?The study findings provide evidence into the value of care coordination from the perspective of consumers living with chronic conditions and other complex health and psychosocial issues. The findings also extend evidence into person- and consumer-centred care through understanding the qualities of care coordination practice that promote authenticity, integrity and positive health outcomes. Listening is identified as a critical element of authentic, values-based care, and as a care coordination intervention. Finally, the study demonstrates that inclusive, co-design research is feasible in this service context, and a larger-scale Experience-Based Co-Design study is recommended to investigate how stakeholders understand the function of care coordination services to promote health and prevent hospital readmissions and improve consumer participation. What are the implications for practitioners?The study informs practitioners of consumer lived experience of care coordination. Practitioners are recommended to apply the findings to practice by adopting an authentic, values-based and person-centred care approach described in the study findings. Service improvement initiatives are recommended to focus on increasing awareness of care coordination services through consumer participation and the meaningful inclusion of consumer voice, which could focus on education for referring health and social care professionals.
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Nguyen, Tan Minh, Utsana Tonmukayakul, and Hanny Calache. "A Cost Analysis of an Outreach School-Based Dental Program: Teeth on Wheels." Children 8, no. 2 (February 18, 2021): 154. http://dx.doi.org/10.3390/children8020154.
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Background: This study evaluated an outreach mobile dental service called Teeth on Wheels (TOW). The dental program targeted Australian children from low household income, who are eligible for the Child Dental Benefits Scheme (CDBS) in Victoria, Australia. The program is complemented with a school-based oral health promotion element. Methods: A retrospective cohort study was performed with a convenience sample. Children must have had at least three dental examinations during the 2016–2019 calendar years to be included in the study. Comparisons were made between the 2016–17 and 2018–19 calendar years. It was hypothesised that the program would result in reduced costs and the number of restorations and extractions in the latter period. Results: A total of 414 children were included in the analysis. The total mean costs of the program per child reduced from AU$605.3 in 2016–17 to AU$531.1 in 2018–19. The results showed an overall mean reduction in all restorations and extractions performed, but only statistical significance was noted for reductions of restored deciduous teeth. Conclusions: This outreach program, which is focused on prevention and minimally invasive dentistry, can be a promising alternative model of delivery for dental services in young children.
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Naccarella, Lucio, Michelle Raggatt, and Bernice Redley. "The Influence of Spatial Design on Team Communication in Hospital Emergency Departments." HERD: Health Environments Research & Design Journal 12, no. 2 (September 20, 2018): 100–115. http://dx.doi.org/10.1177/1937586718800481.
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Objective: To identify spatial design factors that influence informal interprofessional team-based communication within hospital emergency departments (EDs). Background: Effective team communication in EDs is critical for interprofessional collaborative care and prevention of serious errors due to miscommunication. Limited evidence exists about how informal communication in EDs is shaped by the physical workspace and how workplace design principles can improve the quality of ED team communication. Method: Two health services with four hospital sites in Victoria, Australia, participated. A multistage mixed-methods approach used (1) an anonymous online communication network survey ( N = 103) to collect data on patterns and locations of informal interprofessional team communication among ED staff, (2) focus groups ( N = 37) and interviews ( N = 3) using photoelicitation to understand the perspectives of ED staff about how spatial design influences team communication, and (3) validity testing of preliminary findings with executives and ED managers at the participating sites. Results: Informal communication with peers and within discipline groups on nonspecific areas of the ED was most common. Three key factors influenced the extent to which ED workspaces facilitated informal communication: (1) staff perceptions of privacy, (2) staff perceptions of safety, and (3) staff perceptions of connectedness to ED activity. Conclusion: Our research supports the proposition that ED physical environments influence informal team communication patterns. To facilitate effective team communication, ED workspace spatial designs need to provide visibility and connectedness, support and capture “case talk,” enable privacy for “comfort talk,” and optimize proximity to patients without compromising safety.
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Hopkins, Aislinn E., Emily B. Douglas, and Megan S. Ady. "Sexual Health Preventive Services." Physician Assistant Clinics 7, no. 1 (January 2022): 117–25. http://dx.doi.org/10.1016/j.cpha.2021.08.011.
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Desai, Bhakti. "Preventive Oral Health Services." Journal of the American Dental Association 151, no. 7 (July 2020): 476. http://dx.doi.org/10.1016/j.adaj.2020.05.014.
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Callander, Emily Joy, Christine Andrews, Kirstine Sketcher-Baker, Michael Christopher Nicholl, Tanya Farrell, Shae Karger, and Vicki Flenady. "Safer Baby Bundle: study protocol for the economic evaluation of a quality improvement initiative to reduce stillbirths." BMJ Open 12, no. 8 (August 2022): e058988. http://dx.doi.org/10.1136/bmjopen-2021-058988.
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IntroductionStillbirth continues to be a public health concern in high-income countries, and with mixed results from several stillbirth prevention interventions worldwide the need for an effective prevention method is ever present. The Safer Baby Bundle (SBB) proposes five evidence-based care packages shown to reduce stillbirth when implemented individually, and therefore are anticipated to produce significantly better outcomes if grouped together. This protocol describes the planned economic evaluation of the SBB quality improvement initiative in Australia.Methods and analysisThe implementation of the SBB will occur over three state-based health jurisdictions in Australia—New South Wales, Queensland and Victoria, from July 2019 onwards. The intervention is being applied at the state level, with sites opting to participate or not, and no individual woman recruitment. The economic evaluation will be based on a whole-of-population linked administrative dataset, which will include the data of all mothers, and their resultant children, who gave birth between 1 January 2016 and 31 December 2023 in these states, covering the preimplementation and postimplementation time period. The primary health outcome for this economic evaluation is late gestation stillbirths, with the secondary outcomes including but not limited to neonatal death, gestation at birth, mode of birth, admission to special care nursery and neonatal intensive care unit, and physical and mental health conditions for mother and child. Costs associated with all healthcare use from birth to 5 years post partum will be included for all women and children. A cost-effectiveness analysis will be undertaken using a difference-in-difference analysis approach to compare the primary outcome (late gestation stillbirth) and total costs for women before and after the implementation of the bundle.Ethics and disseminationEthics approval for the SBB project was provided by the Royal Brisbane & Women’s Hospital Human Research Ethics Committee (approval number: HREC/2019/QRBW/47709). Approval for the extraction of data to be used for the economic evaluation was granted by the New South Wales Population and Health Services Research Ethics Committee (approval number: 2020/ETH00684/2020.11), Australian Institute of Health and Welfare Human Research Ethics Committee (approval number: EO2020/4/1167), and Public Health Approval (approval number: PHA 20.00684) was also granted. Dissemination will occur via publication in peer reviewed journals, presentation at clinical and policy-focused conferences and meetings, and through the authors’ clinical and policy networks.This study will provide evidence around the cost effectiveness of a quality improvement initiative to prevent stillbirth, identifying the impact on health service use during pregnancy and long-term health service use of children.
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Gough, David. "Preventive services." Child Abuse Review 12, no. 3 (2003): 141–44. http://dx.doi.org/10.1002/car.804.
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Adler, Nancy E. "Community preventive services." American Journal of Preventive Medicine 24, no. 3 (April 2003): 10–11. http://dx.doi.org/10.1016/s0749-3797(02)00649-9.
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Simpson, Grahame, Bernie Franke, and Lauren Gillett. "Suicide Prevention Training Outside the Mental Health Service System." Crisis 28, no. 1 (January 2007): 35–43. http://dx.doi.org/10.1027/0227-5910.28.1.35.
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Abstract. The training needs of staff working in mainstream (i.e., noncrisis) health settings with client groups that have moderate levels of suicide risk have not been extensively addressed. An initiative to train rehabilitation and disability staff working in the field of traumatic brain injury (TBI) is described. A program was adapted from a generic state health department training program, and disseminated by means of established training networks within the brain injury field. Program efficacy was evaluated as the training was provided across the state of Victoria in a series of 1-day workshops. Participants (n = 86) completed two evaluation measures designed for this purpose (objective knowledge test, self-rating of knowledge and skills) on three occasions (pre- and postworkshop, 6-month follow-up). Compared to a control group of rehabilitation and disability workers who did not receive the training (n = 27), the workshop participants made significant gains in objective knowledge and reported skills, and maintained these gains at the 6-month follow-up. The Suicide Interview Response Inventory-2 ( Neimeyer & Pfeiffer, 1994 ) was administered to a subgroup of participants as a validating measure, and correlated significantly with scores from the objective knowledge test. This process may provide a template for developing more fine-grained suicide prevention strategies among other health-related at-risk groups.
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Sox, Harold J. "Preventive Health Services in Adults." New England Journal of Medicine 330, no. 22 (June 2, 1994): 1589–95. http://dx.doi.org/10.1056/nejm199406023302208.
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Golen, Toni H., and Hope A. Ricciotti. "Preventive Health Services for Women." Obstetrics & Gynecology 134, no. 3 (September 2019): 463–64. http://dx.doi.org/10.1097/aog.0000000000003436.
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Abdus, Salam, and Thomas M. Selden. "Preventive Services for Adults." Medical Care 51, no. 11 (November 2013): 999–1007. http://dx.doi.org/10.1097/mlr.0b013e3182a97bc0.
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Burton, Lynda C., Pearl S. German, and Sam Shapiro. "A Preventive Services Demonstration." Medical Care 35, no. 11 (November 1997): 1149–57. http://dx.doi.org/10.1097/00005650-199711000-00006.
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Cooper, James K., and Carolyn M. Clancy. "Health Services Research Agenda for Clinical Preventive Services." American Journal of Preventive Medicine 14, no. 4 (May 1998): 331–34. http://dx.doi.org/10.1016/s0749-3797(97)00056-1.
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Ashburn, Ann, Ruth Pickering, Emma McIntosh, Sophia Hulbert, Lynn Rochester, Helen C. Roberts, Alice Nieuwboer, et al. "Exercise- and strategy-based physiotherapy-delivered intervention for preventing repeat falls in people with Parkinson’s: the PDSAFE RCT." Health Technology Assessment 23, no. 36 (July 2019): 1–150. http://dx.doi.org/10.3310/hta23360.
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Background People with Parkinson’s disease are twice as likely to experience a fall as a healthy older person, often leading to debilitating effects on confidence, activity levels and quality of life. Objective To estimate the effect of a physiotherapy programme for fall prevention among people with Parkinson’s disease. Design A multicentre, pragmatic, investigator-masked, individually randomised controlled trial (RCT) with prespecified subgroup analyses. Setting Recruitment from NHS hospitals and clinics and community and social services in eight English regions with home-based interventions. Participants A total of 474 people with Parkinson’s disease (i.e. Hoehn and Yahr scale stages 1–4) were recruited: 238 were assigned to a physiotherapy programme and 236 were assigned to usual care. Random allocation was 50 : 50. Interventions All participants received routine care; the usual-care group received an information digital versatile disc (DVD) and a single advice session at trial completion. The intervention group had an individually tailored, progressive, home-based fall avoidance strategy training programme with balance and strengthening exercises: PDSAFE. Main outcome measures The primary outcome was the risk of repeat falling, collected by self-report monthly diaries between 0 and 6 months after randomisation. Secondary outcomes included near-falls, falls efficacy, freezing of gait (FoG), health-related quality of life, and measurements taken using the Mini-Balance Evaluation Systems Test (Mini-BESTest), the Chair Stand Test (CST), the Geriatric Depression Scale, the Physical Activity Scale for the Elderly and the Parkinson’s Disease Questionnaire. Results PDSAFE is the largest RCT of falls management among people with Parkinson’s disease: 541 patients were screened for eligibility. The average age was 72 years, and 266 out of 474 (56%) participants were men. Of the 474 randomised participants, 238 were randomised to the intervention group and 236 were randomised to the control group. No difference in repeat falling within 6 months of randomisation was found [PDSAFE group to control group odds ratio (OR) 1.21, 95% confidence interval (CI) 0.74 to 1.98; p = 0.447]. An analysis of secondary outcomes demonstrated better balance (Mini-BESTest: mean difference 0.95, 95% CI 0.24 to 1.67; p = 0.009), functional strength (CST: p = 0.041) and falls efficacy (Falls Efficacy Scale – International: mean difference 1.6, 95% CI –3.0 to –0.19; p = 0.026) with near-falling significantly reduced with PDSAFE (OR 0.67, 95% CI 0.53 to 0.86; p = 0.001) at 6 months. Prespecified subgroup analysis (i.e. disease severity and FoG) revealed a PDSAFE differing effect; the intervention may be of benefit for people with moderate disease but may increase falling for those in the more severe category, especially those with FoG. Limitations All participants were assessed at primary outcome; only 73% were assessed at 12 months owing to restricted funding. Conclusions PDSAFE was not effective in reducing repeat falling across the range of people with Parkinson’s disease in the trial. Secondary analysis demonstrated that other functional tasks and self-efficacy improved and demonstrated differential patterns of intervention impact in accordance with disease severity and FoG, which supports previous secondary research findings and merits further primary evaluation. Future work Further trials of falls prevention on targeted groups of people with Parkinson’s disease are recommended. Trial registration Current Controlled Trials ISRCTN48152791. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 36. See the NIHR Journals Library website for further project information. Sarah E Lamb is funded by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) at Oxford Health NHS Foundation Trust, the NIHR Oxford Biomedical Research Centre at the Oxford University Hospitals NHS Foundation Trust and CLAHRC Oxford. Victoria A Goodwin is supported by the NIHR Collaborations for Leadership in Applied Health Research and Care in the South West Peninsula (PenCLAHRC). Lynn Rochester is supported by the NIHR Newcastle Biomedical Research Centre based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University. The research was also supported by the NIHR Newcastle Clinical Research Facility Infrastructure funding. Helen C Roberts is supported by CLAHRC Wessex and the NIHR Southampton Biomedical Research Centre.
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Cooke, Bryan E. M. "HEALTH PROMOTION, HEALTH PROTECTION, AND PREVENTIVE SERVICES." Primary Care: Clinics in Office Practice 22, no. 4 (December 1995): 555–64. http://dx.doi.org/10.1016/s0095-4543(21)00546-7.
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Hahn, D. L. "Delivery of Preventive Services." Journal of the American Board of Family Medicine 13, no. 3 (May 1, 2000): 228–29. http://dx.doi.org/10.3122/15572625-13-3-228b.
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