To assess Aboriginal and Torres Strait Islander people's knowledge about coronavirus disease 2019 (COVID-19) vaccines, and their attitudes to and behaviours regarding COVID-19 and influenza vaccinations.
Web-based survey.
Australia (excluding the Northern Territory), 1 October 2021 to 31 May 2022.
Convenience sample of Aboriginal and Torres Strait Islander people aged 16 years or older living in Australia.
Proportions of respondents who reported knowledge about COVID-19 vaccines, and attitudes to and behaviours regarding COVID-19 and influenza vaccinations.
A total of 530 people provided valid survey responses; their median age was 27 years (interquartile range, 23–38 years), 255 (48%) were from urban areas, and 309 (58%) were men. Of the 480 participants (91%) who provided complete survey questions (including sex and location information), larger proportion of men than women believed COVID-19 vaccines were very or extremely trustworthy (219, 79% v 124, 61%) and very or extremely effective (212, 76% v 138, 68%). The prevalence of COVID-19 vaccination was lower among respondents aged 60 years or older than among those aged 16–29 years (adjusted prevalence ration [PR], 0.81; 95% confidence interval [CI], 0.66–0.99). After adjusting for socio-demographic factors, the association between intention to receive the influenza vaccine and receiving the COVID-19 vaccine was statistically significant (adjusted PR, 1.18; 95% CI, 1.09–1.27).
The high levels of trust in COVID-19 vaccines and their effectiveness indicate that Aboriginal and Torres Strait Islander people are confident about their safety and efficacy and understand the importance of vaccination. The findings also highlight a positive attitude to vaccination and a commitment to preventive health measures among Aboriginal and Torres Strait Islander people.
To understand patients’ and carers’ experiences of virtual medical care delivered into rural and remote hospitals.
Qualitative study using semi-structured interviews.
Interviews were conducted between 7 June 2022 and 21 February 2023. Participants were people who had received a virtual medical service from the Virtual Rural Generalist Service (VRGS), and their carers, in rural and remote hospitals within the Western NSW Local Health District.
Acceptability of, access to, quality of and appropriateness of care provided by the VRGS.
We interviewed 43 patients and carers about their experiences of VRGS services received in an emergency department or inpatient setting. About half of our participants thought that virtual medical care (supported by in-person nursing staff) was highly acceptable and equivalent to in-person care. For the remaining participants, virtual care was seen as being an acceptable alternative if in-person care was not available. Patients reported that the model met their immediate needs, even if the virtual delivery mode was not their preference. VRGS doctors were generally seen as skilled and personable, and acceptability of virtual care increased with more experience of it. A key perceived benefit of virtual care was increased access to medical care without the need to travel long distances. Hospital-based virtual care was not considered less appropriate for older adults or children.
Virtual care in a rural hospital setting, such as that delivered by the VRGS, is broadly acceptable to patients and carers. While most would prefer to have a doctor physically present, patients and carers are accepting of the need for virtual care to supplement in-person care in rural and remote areas. Patients and carers who experience hospital-based virtual care perceive that it can provide good quality medical care and meet many of their needs.
To explore the experiences of clinicians delivering, facilitating, and potentially affected by a hybrid virtual medical model servicing rural and remote hospitals in western New South Wales.
Qualitative study using semi-structured focus groups and individual interviews, conducted between 7 April 2022 and 16 March 2023, with rural generalist doctors delivering the Virtual Rural Generalist Service (VRGS) within the Western NSW Local Health District, local site staff, and local general practitioner visiting medical officers (GP VMOs).
Key themes in clinician experience of the model and recommendations for improved experience, based on qualitative content analysis.
We interviewed 12 VRGS doctors, 25 site nursing staff and nine GP VMOs. Clinicians were overwhelmingly positive about the VRGS, seeing it as providing good quality care and being an innovative and translatable solution to rural workforce challenges. In-person site visits by VRGS doctors were highly valued, especially by local site staff, for team building, skill building and increasing VRGS doctors’ understanding of the local context. The VRGS model relies on nursing availability and skill, and creates additional workload for nurses. Nurses in isolated sites valued the clinical support provided by the VRGS. Overall, most GP VMOs valued the fatigue relief offered by the VRGS; however, some viewed the VRGS as diminishing local doctors’ autonomy and the viability of their positions.
The hybrid VRGS model is widely accepted by clinicians as providing good quality care for patients and high job satisfaction for providers. The service supports the local health workforce and makes rural medical positions more attractive and sustainable. The in-person shift requirement is central to the model's effectiveness and acceptability. Further investment is needed to train and resource local nurses who play an integral role in providing virtual medical care.
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