Public Health Research & Practice最新文献

Objectives and importance of study Adequate funding for comprehensive strategies is crucial to eliminating violence against women. This study examined funding committed during a major policy initiative aimed at reducing violence against women in Australia between 2010 and 2023. Study type A retrospective review of federal, state and territory government budget documents to estimate funding levels and examine the distribution of resources across types of strategies aimed at addressing violence against women in Australia. Methods Review and data extraction of budget estimates and activity descriptions addressing violence against women and gender inequality during the time of Australia's National Plan to Reduce Violence Against Women and their Children . Mixed-method analysis explored trends in funding over time by jurisdiction and strategy type and identified priority actions. Results Of the 508 papers screened, 201 documented relevant information with over 900 extractions for activities addressing violence against women (n =797) and gender inequality (n =110), totalling an estimated A$12.1billion. Rather than a steady investment, funding fluctuated, and jurisdictional differences occurred. Supporting people impacted by violence, raising workforce capacity and developing systems to strengthen the response were supported. Primary prevention, incorporating awareness-raising and promoting gender equality, received fewer resources overall, with funding directed towards education, workplace and sports settings. Conclusions During a critical time of action to reduce violence against women, increased government funding occurred, supporting diverse strategies. However, a lack of clarity and consistency in budget reporting contributed to uncertainty in total funding committed over this timeline. Having a fiscal strategy over the entire action plan will embed long-term funding and improve future planning and monitoring.

Objectives and importance of study Public health aims to improve health at scale through a variety of preventive, protective and response measures. As a deep and broad profession, public health necessitates a wide variety of roles, specialisations and career pathways. This breadth can lead to many public health students experiencing career uncertainty, particularly related to awareness of career options. Ensuring public health education prepares students for the workplace is essential to meet workforce needs. Understanding where graduates work, what they do and what skills they possess can inform career decisions of students and curriculum design to address industry requirements. This study aims to describe and discuss the employment outcomes of Australasian public health alumni using LinkedIn data. Study type Descriptive, observational study, using secondary data. Methods Data on 14,424 alumni, who graduated between 2011 and 2020, were collected from the alumni section of 36 Australasian university LinkedIn pages. Data on geographic location ('where they live'), employment ('where they work' and 'what they do') and self-reported skills ('what they are skilled at') were recorded and analysed. Results Nearly all (95%) of the alumni had lived in an Australian location. Alumni most frequently worked in health care, community and social services, research, or education roles. Major employers included universities (43%), government (27%) and healthcare organisations (22%). Microsoft Office, public health, research skills, leadership, public speaking and project management were the most frequently reported skills, accounting for 51% of entries. Conclusions Tracking alumni via networking sites can provide institutions with valuable information on the skill sets required for employment within the sector and on the nature and scope of employment opportunities for graduates. This information can be used to develop and renew curricula of public health training programs to meet industry requirements. It also offers an opportunity to identify emerging trends, augmenting the requirement for a current training/workplace nexus.

Objectives Healthcare providers play a critical role in increasing vaccine coverage and public confidence in the safety of vaccines. The SARS-CoV-2 pandemic and COVID-19 vaccine responses have posed unique challenges to vaccine safety surveillance and community confidence in immunisation. The need to maintain confidence for high vaccine uptake, reinforces the need for a holistic, robust approach to post-licensure vaccine safety surveillance. This study aimed to examine healthcare providers' perceptions of vaccine safety surveillance. Methods A cross-sectional study with Australian healthcare providers was conducted between November and December 2021. General practitioners, nurses, and pharmacists in current or previous roles administering vaccines were invited to participate in an online survey that assessed their awareness of, and practices related to, vaccine safety surveillance systems. The survey was disseminated via healthcare provider professional networks. Results Of the 562 completed surveys, 552 were included in the analysis. The majority of the healthcare providers (96%) reported being aware that Australia has mechanisms in place to monitor the safety of vaccines after they are approved for use. However, almost a third of participants were not aware of the AusVaxSafety active vaccine safety surveillance system. Among healthcare providers, nurses were more aware of surveillance systems and reported the highest utilisation of vaccine safety surveillance data in their clinical practice. Participants reported confidence in the safety of vaccines as a result of the existence of vaccine safety surveillance systems. Conclusions Healthcare providers in this study showed confidence in the safety of vaccines. However, our findings indicate that despite providers demonstrating increased confidence as a result of the existence of vaccine safety surveillance systems, further efforts should be made to increase immunisation providers' awareness of the systems, particularly in regards to the accessibility and utility of AusVaxSafety vaccine safety data.

Objective The objective of this study was to examine the experiences of Australian residents living in mould-affected homes; the perceived physical and mental health effects of indoor mould exposure; and personal, social, and institutional barriers to remediation of homes affected by mould. Methods Using a multi-method approach, this study combined analyses of data from semi-structured, in-depth interviews conducted in Melbourne (n =11) with open-ended responses to a large national household survey on mould exposure in Australia (N =598) to explore people's direct experiences of living in mould-affected housing. Findings are presented as a narrative description. Results Participants reported mould exposure to be associated with poor physical health, including respiratory and allergic symptoms and exacerbation of chronic illness. Participants also reported detrimental effects on their mental wellbeing, reporting anxiety, stress, decreased self-esteem, and decreased feelings of safety. Numerous barriers to remediation were identified, including a lack of knowledge of appropriate actions, costs, and time needed to arrange and/or conduct remediation works. Residents of the rental sector faced additional challenges, including dependence on the quality of landlord-tenant relations and lack of effective policy enforcement. Conclusions These findings support a policy focus on initiatives to assist rental tenants who have mould in their homes and to provide more information to homeowners on strategies for mould removal. The study underscores the need for better regulatory mechanisms to enforce minimum standards for buildings and for health assessments and treatments to consider indoor mould exposure.

Background In Victoria, Aboriginal maternal and infant health services are funded by the Victorian Government with coordination led by the Victorian Aboriginal Community Controlled Health Organisation (VACCHO). This research aims to compare the distribution of these services with the Aboriginal infant population across all local government areas (LGAs) of Victoria and identify gaps in service availability. Method Statewide mapping of Aboriginal maternal and infant health services in Victoria was undertaken in 2023, and Aboriginal and Torres Strait Islander population data for each LGA in Victoria were sourced from the 2021 Australian Bureau of Statistics Census. Data relating to the geographical location of Aboriginal-specific maternal and infant health services were collected from the websites of VACCHO and the Victorian Department of Health. These data were geocoded and overlaid onto LGAs using a geographical mapping software program. Data were analysed via SPSS, a statistical analysis program. Results There was considerable variation in the availability of Aboriginal-specific maternal and infant health services across both metropolitan and regional areas of Victoria. Only 21 of 79 (27%) Victorian LGAs offered Aboriginal-specific services in either pregnancy or early childhood, and 12 (15%) offered continuity of care throughout pregnancy and early childhood specifically for Aboriginal families. Twenty-seven out of 79 (34%) LGAs offered no specific Aboriginal maternal and infant services. However, the median population of Aboriginal infants in LGAs with some services was significantly higher than in LGAs offering no services (81.0 vs 19.5, P 100 Aboriginal infants had no specific Aboriginal maternal and infant health service. Conclusion Aboriginal-specific maternal and infant health services have been addressing the healthcare needs of Aboriginal families across Victoria since their inception. There does, however, need to be further targeted investment in Aboriginal Community Controlled Health Organisations so that developing communities within Victoria can access continuity of maternal and infant healthcare across the perinatal periods to improve the overall health of future generations of Aboriginal children and families.

The COVID-19 pandemic brought epidemiology into public focus globally. Understanding patterns and determinants of disease spread was central to risk assessment and the modelling of drivers of transmission to forecast outcomes under different intervention scenarios. Epidemiological analytics, including the reproduction number, were being discussed by the media and the public in ways epidemiologists and biostatisticians could not have foreseen. Yet the statistics being reported were largely confined to two ends of the evidence spectrum - at one end, raw case counts, hospitalisations and deaths, and at the other, sophisticated statistical modelling based on disease dynamics averaged at the whole-of-population level. Other core epidemiological analytic methods that add a more nuanced understanding of variation in disease transmission within and across populations, and risk of infection, were underrepresented. In Australia, for example, the purposeful collection of data to estimate subpopulation-specific case rates, generate relative risks across subpopulations and allow meaningful interpretation within and across populations was limited. This also hampered the real-world evaluation of specific health interventions, including vaccination, and the generation of updated population-specific estimates for statistical model parameters. This was a global phenomenon, though some countries did better than others. What was fundamentally missing was a clear investment in, and coordinated approach to, the quality of surveillance data needed for (a) tracking disease transmission and the degree of control achieved, both of which changed over time, and (b) public communication. The independent inquiry into the Australian Government's COVID-19 Response had evidence generation as a central theme, and investment in evidence synthesis capability and data sharing as clear recommendations for the way forward. The importance of evidence was also raised in discussions informing the draft global Pandemic Agreement. This remains a worrying gap in pandemic readiness, including in well-resourced countries such as Australia where the nuance in public health policy was constrained by the reliance on basic descriptive epidemiology, urban-focused population-level modelling and data insights imported from other countries.

Objectives and importance of study To summarise current evidence on the facilitators and barriers to offering vaping cessation support from the perspective of health professionals (HPs) with client-facing roles. Study type A scoping review following the Joanna Briggs Institute methodology. Methods Six databases were searched for relevant peer-reviewed articles published in English between 2003 and 2024. All articles were screened by two reviewers independently, based on pre-specified eligibility criteria. Data extraction and analyses were informed by the Theoretical Domains Framework (TDF). Results A total of 10,992 articles were screened; 21 publications met the inclusion criteria. Data extracted were mapped to the TDF (12 of the 14 domains were used). Barriers were more commonly reported than facilitators and included lack of knowledge, lack of training and competing priorities; the most commonly reported facilitators were HPs' sense of responsibility and willingness to provide e-cigarette cessation support. Most of the studies included were from the US and employed quantitative surveys. Most of the studies screened focused on the utility of e-cigarettes as cessation aids for combustible tobacco smoking, highlighting a gap in the interventional evidence on e-cigarette cessation. Conclusions More primary qualitative studies, including in Australia, are needed to understand the complexities of offering vaping cessation support. Although a range of HPs were represented in the review, further studies could analyse allied HPs' views separately from medical professionals' views.

Primary health care provides a comprehensive range of preventive care for the Australian population. Prevention is now a core activity of general practice, and engagement of a range of non-medical providers and digital tools has enhanced its capacity. There are promising strategies to further engage primary health care from both the government and the profession. However, funding, workload and systemic barriers have frustrated adoption and implementation over the past decade. These need to be addressed for further progress to be achieved.

Objectives The value of engaging health service users and their families (consumers) in research is increasingly being recognised in planning and evaluating health services to meet diverse needs. This project aimed to co-design a strategic consumer involvement framework and implementation plan for a public Australian hospital and health service. Methods A co-design approach was used to adopt a framework and develop an implementation plan across five stages: (1) an initial consultation with key stakeholders, (2) a survey of health service staff about involving consumers in research at the health service, (3) three group sessions using Nominal Group Technique with health service consumers and staff that explored barriers and solutions to involving consumers, (4) data synthesis, and (5) a workshop of key stakeholders to develop and refine the implementation plan. Three consumer partners contributed to protocol development, research design, data analysis, and manuscript writing. Results Survey and group session data highlighted a need for governance, infrastructure, capacity building, and leadership and culture within the organisation to support the involvement of consumers in research at the health service. These aligned with the South Australian Health and Medical Research Institute (SAHMRI) Framework domains. Implementation strategies were adjusted on the basis of insights from the local context to facilitate adoption within the health service. Conclusions By better supporting consumers and researchers to work together in health service research, organisations can enhance the relevance, quality, and impact of their research efforts. This project provides a valuable blueprint for developing a local, contextualised approach to promoting effective consumer-researcher relationships in Australian public health services.