Rural and remote health最新文献

Introduction: Farmers are among the occupational groups with the highest risk of mental illness. This exploratory study aimed to investigate how Norwegian farmers perceive different facilitators of and barriers to mental wellbeing in their everyday lives, and the possible relationships between these factors and overall mental wellbeing.

Methods: This study included 265 Norwegian farmers (142 males and 123 females) who responded to an online survey. The five-item WHO Well-Being Index was employed to evaluate farmers' mental wellbeing.

Results: The results showed that 34.7% of the respondents reported wellbeing scores that indicated they should be further screened for major depression. Female farmers reported significantly lower mental wellbeing scores than male farmers. Furthermore, full-time farmers had lower wellbeing scores than part-time farmers. The factors that most respondents perceived to be barriers to wellbeing in everyday life were unstable economics and a lack of appreciation for their work. The primary facilitators were stable and secure economics and a good social network within and outside of agriculture.

Conclusion: Analysis suggests that perceived barriers seem to have a higher importance for farmers' wellbeing than the perception of facilitators. Future studies should further investigate the effects of individual barriers on mental wellbeing.

Introduction: The goal of this scoping review was to identify and synthesize what is known about the health outcomes and healthcare access experiences of women who are currently incarcerated or recently released from prison/jail in rural areas.

Methods: We followed the Joanna Briggs Institute methodology for scoping reviews. The population of interest was adult women or gender-diverse people who are either currently incarcerated or had been released in the prior year. The concepts of interest were health outcomes and health access experiences. The context was rural institutions of incarceration and rural communities in the post-incarceration period.

Results: We identified 48 relevant studies conducted in the US, Australia and England, published between 2001 and 2024. Ten studies took place in a rural community up to 1 year post-incarceration, and the remaining 38 took place in a rural prison or jail. The most common outcomes of interest were those related to substance use.

Conclusion: Women in rural institutions of incarceration experience a general lack of healthcare options and availability, and may have elevated needs related to substance use. Women released into rural communities face barriers to accessing care, often relying on relationships to facilitate access to health care and social services, in lieu of the clinical and transitional services available in urban areas. Gaps in research include evidence on health outcomes not related to substance use, and experiences accessing primary care both while incarcerated and after release.

Introduction: WHO encourages decentralising mental health care away from the tertiary locus of care into lower levels of care so as to reform mental healthcare worldwide. Recently, attempts have been made to facilitate the integration of public mental health care into general healthcare systems in South Africa. It is well established that the country's public healthcare system faces numerous multifaceted challenges - including very limited human, structural and material resources needed to accommodate and treat patients. We studied the experiences and opinions of public healthcare workers at primary healthcare clinics and the associated referral hospitals, focusing mainly on exploring their views on the ability and readiness for access to and provision of mental health to state health patients.

Methods: The Mental Health Knowledge Schedule (MAKS), the Mental Illness: Clinicians' Attitudes Scale (MICA-4) and a purpose-made questionnaire were used for data collection. The data from the MAKS and MICA-4 were imported into IBM SPSS Statistics Software to yield descriptive information, and Spearman's rank correlations were performed between the measures. The purpose-made questionnaire produced descriptive quantitative data and qualitative data that were analysed through conventional content analysis.

Results: Results from the MAKS suggest that participants experienced gaps in mental health knowledge and had fair levels of familiarity and ability to recognise different mental health conditions. Results from the MICA-4 suggest that participants in our study generally displayed a positive attitude towards people with mental illness and aspects involving psychiatry. Quantitative results from the purpose-made questionnaire describe aspects around mental health services, training, resources and care. Qualitative findings suggest healthcare workers wished for more mental-health-specific resources and contact with the healthcare system to facilitate interventions and care.

Conclusion: This research presents possible solutions to the challenges faced in public mental health care. Some of these solutions are within workers' control, while many of the solutions to the successful integration of more comprehensive basic care are out of their ambit of control, remaining locked up in policy and implementation rather than in field-level practice.

Introduction: Supplement use is common among women experiencing menopause and perimenopause. Previous studies have identified regional, cultural, and ethnic differences in supplement use patterns and have identified a high prevalence of supplement use among rural populations. The objective of this study was to characterize supplement use among an ethnically diverse population of perimenopausal and menopausal women living in a rural region of Hawaiʻi in the US.

Methods: From May to August 2023, women aged over 40 years presenting for care at an academic women's health clinic were recruited to participate in this cross-sectional study. A 10-minute survey including questions concerning demographic characteristics and supplement use was administered. Descriptive statistics were used to describe data obtained from the survey.

Results: One hundred participants completed the survey. Of these, most participants identified as Asian, White, or Native Hawaiian. Ninety-four percent of respondents reported using at least one supplement in the previous 6 months. Most participants (60%) used four or more supplements, and the mean monthly cost was US$55 (A$83). The most commonly reported supplements included vitamin D, calcium, a multivitamin, and magnesium. Health professionals were the most commonly identified source of information regarding supplement use (69%). The most common motivations for supplement use were promotion of general health (51%) and replacement of dietary deficiencies (11%).

Conclusion: The prevalence of supplement use among perimenopausal and menopausal women in rural Hawaiʻi is higher than previously published measures of supplement use among similarly aged women in the continental US, the UK, and Canada. In the setting of such widespread use, clinicians caring for this population may consider initiating thoughtful discussions with patients on the risks and benefits of using these products.

Introduction: Despite investment in maternal-child health programs, there has been little impact on the health outcomes of Indigenous mothers and their children, creating a need to understand how programs can be successfully implemented. Community input is essential for successful programs; however, there is little research exploring the perspectives of frontline workers providing these programs. To gain a better understanding of how to support maternal-child health program success a research partnership was formed with the KidsFirst North program in Northern Saskatchewan, Canada. Using a community-based participatory research approach, this study was codeveloped to (1) explore families', frontline workers', and administrators' perceptions of factors that contribute to the success and barriers of a program for Indigenous families; and (2) describe the current role of frontline workers within health program planning, implementation, and evaluation.

Methods: From September 2019 to January 2020, data were collected through in-person meetings, focus groups, and semi-structured interviews with KidsFirst North families (n=9), frontline workers (n=18), and administrators (n=7) from 11 sites in Northern Saskatchewan. Data were analyzed using the Collective Consensual Data Analytic Procedure.

Results: The identified factors of program success included the importance of staff, where staff demonstrated certain positive characteristics and created a welcoming atmosphere for families; community events that were open to the entire community; and the integration of Indigenous culture in the program. Program barriers included jurisdictional policy that negatively impacted frontline workers, a lack of father inclusion in program activities, and community challenges such as a lack of access to other services within the community. All frontline workers had a role in program delivery, most reported involvement in program development and planning, and approximately half were included in program evaluation.

Conclusion: Factors of success and barriers from the KidsFirst North project have illustrated elements to build on and areas to address in public health program planning, implementation, and evaluation of maternal-child health programs that serve Indigenous families. KidsFirst North has demonstrated ways a contemporary maternal-child health program can utilize frontline workers outside of program delivery to influence all aspects of health program planning, implementation, and evaluation. Contributing to the evidence base of maternal-child health programs for Indigenous families may help foster the success of public health programs; inform the role of frontline workers in health program planning, implementation, and evaluation; and positively impact the health of Indigenous children and families.

Introduction: Young people with unaddressed legal matters are at risk of adverse consequences to their health and wellbeing. Health justice partnerships (HJPs) can support young people in regional areas to address their legal matters and reduce consequential deleterious impacts. A health justice partnership for youth (HJPY) was established in western Victoria, Australia. The program was unique for both its regional location and focus on supporting young people with their legal matters. This article reports on research that was conducted alongside the program, examining (1) the perceptions of regional young people and workers about the impact of legal matters on the health and wellbeing of young people and (2) the role of this HJPY in addressing these legal matters on the health of young people.

Methods: Surveys were used to collect data from young people (n=64) attending the HJPY, and youth and allied health workers (n=48) from partner and other agencies. Data about the program were collected by the legal service operating at the time. Data were collected across multiple time points over 6 years, upon commencement and completion of the program.

Results: The findings showed that young people attending the program required assistance for a wide range of legal matters. Upon attending the HJPY, most young people indicated that their unresolved legal matters influenced their health and wellbeing including sleep, stress, concentration and relationships. After attending the program, young people reported perceived improvements in their health and wellbeing, with workers observing improvements in young people's mental health, mood and self-confidence.

Conclusion: The research highlights the importance of HJPs to young people in addressing their unmet legal needs, with resolution of these matters supporting improved health and wellbeing and enabling them to move forward and focus on other areas of their lives. Youth and allied health workers in regional areas are integral in the early identification of young people with legal matters. They are integral to facilitating suitable referral pathways and services that support young people with their unresolved legal matters.

Introduction: Australians living in isolated communities are more likely to experience poorer health outcomes as a result of rurality. This article provides a needs assessment of healthcare services in a geographically isolated region of Victoria, Australia.

Methods: The research project employed a mixed-methods design. The study population consisted of members of the isolated communities in Victoria. The incorporation of qualitative data added depth to the quantitative data, ensuring that voices of community members were adequately represented in the needs assessment. Data analysis was undertaken using descriptive statistics and thematic analysis techniques.

Results: Survey respondents from isolated regional locations highlighted the extended travel time and increasing wait times to see a medical practitioner, leading to a delay in seeking healthcare assistance. Respondents were less likely to have access to and use telehealth services, yet highlighted the service as beneficial to isolated regions. Survey findings were supported by in-depth interviews, with participants stating access to care was difficult, providing place-based suggestions of services to remove barriers to care such as a virtual care model and mobile services visiting the isolated regions.

Conclusion: Access, use and facilitation of appropriate place-based health care within isolated Australia has the potential to increase wellbeing and enables residents to remain in regions that hold long historical and familial connections. By incorporating innovative technologies and models of care that have been evaluated across other isolated regions of Australia and globally, there is an opportunity to adapt existing models to conform to a post-COVID world.